Nourianz Copay Assistance Program

Funded

About

The Nourianz Copay Assistance Program offers significant financial benefits to eligible patients using Nourianz. With the Nourianz Copay Assistance Program, patients can pay as little as $20 for a 1-30 day supply of Nourianz while receiving coverage up to $5,000 annually. This program ensures that patients who have insurance coverage for Nourianz can access their medication affordably.

Insurance requirements: Commercially insured

As low as: $20 per fill

Enrollment Forms

Enrollment Form

Benefits

•$5000 annual maximum benefit

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

•Eligible patients pay no more than $20 per 130 day supply ($40 for a 3160 day supply or $60 for a 6190 day supply)

•Min/max days supply allowed: 30 tablets per 30 days for up to 90 days per fill

•Program pays up to $5,000 per calendar year (i.e., January 1st through December 31st)

•Enrollment form must be completed and faxed to 8334474399

•Patients must reenroll annually

•Specialty Pharmacy can enroll patient via a portal

•For more information patient must call phone: 833KKCARES (8335522737), MF, 8AM to 5PM EST

Enrollment Forms

Enrollment Form