Orbactiv Patient Assistance Program

Funded

About

The Orbactiv Patient Assistance Program offers essential support by providing the Orbactiv drug to eligible uninsured patients at no cost. This beneficial program explicitly accommodates both inpatients and outpatients, ensuring greater access to necessary treatment through a simple application process. The Orbactiv Patient Assistance Program is a vital resource for those needing financial relief while receiving important healthcare services.

Insurance requirements: Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Eligible uninsured patients may be able to receive ORBACTIV at no cost

•HCP and patient must sign and complete form; fax to 18558862482

•The program is a replacement program for the unit used on the eligible patient

•Both inpatients and outpatients may be eligible for the ORBACTIV Patient Assistance Program

•Call 18446722284, MondayFriday, 8am8pm ET, for more information or assistance or email orbactivassistanceprogram@melinta.com

Enrollment Forms

Enrollment Form