•Eligible commercially insured patients may pay as little as $0 per month
•Benefit is intended to be credited toward patient outofpocket obligations, including applicable copayments, coinsurance, and deductibles for their medicine; program does not assist with the cost of other medications or office visit fees
•The maximum Program benefit is provided annually, and it expires at the end of the calendar year and will reset every January 1st
•Eligible patients will be automatically reenrolled in the Program on an annual basis if the patient continues to meet all eligibility requirements set forth by the Program
•HCP should fax or email the completed enrollment form to 8553329663 (FAX) or info@everydaysupport.com (EMAIL)
•For assistance or additional information, call 8553291246, Monday–Friday 8 AM–8 PM ET