Nerlynx Quick Start

Funded

About

The Nerlynx Quick Start program provides eligible patients with the opportunity to access Nerlynx, a vital medication, during delays with insurance coverage. Designed specifically for patients prescribed Nerlynx for FDA-approved indications, the Nerlynx Quick Start program supports those with private or commercial insurance by offering a 3-week supply to help manage delays in access. Benefiting patients residing in the US or US territories, the Nerlynx Quick Start program ensures that those pursuing prior authorization or appeals can maintain treatment continuity with potential refills.

Insurance requirements: Commercially insured, Medicare / Medicaid

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients experiencing delays in gaining access to therapy may be able to receive a 3week supply of medication

•If a delay in coverage extends beyond the first 21 days and the patient/provider is actively pursuing coverage through prior authorization/appeal, the patient may be eligible for one 21day refill

•The program may not be combined with another offer and is not eligible to patients without insurance or whose insurer has made a final coverage determination

•HCP should fax the completed Enrollment Form and all supporting documents to Puma Patient Lynx at 8442765153

Enrollment Forms

Enrollment Form