Opzelura On Trac Commercial Bridge Program

Funded

About

The Opzelura On Trac Commercial Bridge Program is designed for patients who have been prescribed Opzelura, providing them with continuous access to their medication even if they face insurance hurdles. This program specifically aids those with a prior authorization denial, allowing them to receive Opzelura while appeals are being processed, ensuring uninterrupted treatment.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients who have received a PA denial may be able to receive a limited quantity while HCP files an appeal

•After a prior authorization denial from the patient's health plan has been received, HCP should complete and fax the Prescription and Enrollment Form to 8778013840

•For assistance or additional information, call 8009321720, Monday through Friday, 8 am–8 pm ET

Enrollment Forms

Enrollment Form