Northera Commercial Copay Assistance Program

Funded

About

The Northera Commercial Copay Assistance Program offers valuable financial support for those prescribed Northera, helping reduce the cost burden for patients. With this program, eligible participants aged 17 and older with insurance coverage for Northera® (droxidopa) can receive assistance, ensuring they pay no less than $10 for each 30-day prescription. This program facilitates pharmacy transactions through McKesson Corporation, and patients benefit from automatic re-enrollment, simplifying continued access to their medication.

Insurance requirements: Commercially insured

As low as: $10 per fill

Enrollment Forms

Enrollment Form

Benefits

•12 maximum fills per year

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Patients must pay at least $10 for each 30day prescription (maximum benefit limit may apply)

•If the patient's total outofpocket pharmacy bill exceeds the cap established by Lundbeck, the patient will be responsible for the additional balance

•Patient can enroll online

•Pharmacies: submit transaction to McKesson Corporation

•Acceptance of card and submission of claims are subject to the LoyaltyScript® program: www.mckesson.com/mprstnc

•Patient is automatically reenrolled in the program

•For questions regarding claim transmission, call the LoyaltyScript program at 18006577613 (8:00 am8:00 pm ET, Monday through Friday)

•For details or if you have other questions about the program, please call 18558206768

Enrollment Forms

Enrollment Form