Assistance Fund: Primary Hyperoxaluria
Not Funded
About
The Assistance Fund: Primary Hyperoxaluria offers vital financial support for patients prescribed Oxlumo or Rivfloza. Designed for U.S. citizens or permanent residents, this program aids those with a primary diagnosis matching the fund, ensuring insurance covers the prescribed treatment. Financial assistance spans copays, coinsurance, deductibles, and other out-of-pocket medical expenses. Patients benefit from immediate conditional approval and must re-enroll annually for continued support.
Insurance requirements: Commercially insured, Medicare / Medicaid
Enrollment Forms
Enrollment Form
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: Yes
•Activation Required: No
Program Details
•Please note the following:
•1. Copay grant programs provide assistance for copays, coinsurance, and deductibles for FDAapproved treatment for the disease named in the disease program ONLY
•2. Financial assistance grant programs provide assistance for other eligible outofpocket costs, such as health insurance premiums and incidental medical expenses, in addition to copay, coinsurance, and deductible assistance on FDAapproved treatment for the disease named in the disease program
•3. This fund may cover offlabel drugs
•Copay and Financial assistance can be utilized by any innetwork pharmacy or site of care able to dispense the medication or provide treatment
•Program offers conditional approval of 30 days of immediate assistance for open programs where funding is available
•Patients will be asked to provide and verify demographic, insurance, and financial information (additional documentation may be requested)
•Approved patients will be granted assistance through the end of the calendar year unless otherwise specified for the applicable program
Enrollment Forms
Enrollment Form