MyPraluent Patient Assistance Program

Funded

About

The MyPraluent Patient Assistance Program provides vital support for individuals requiring Praluent. This program is designed to assist eligible patients by offering Praluent free of charge for up to 12 months for those without insurance or with specific financial hardships. The MyPraluent Patient Assistance Program is committed to ensuring that patients who meet the eligibility criteria receive the necessary medication without financial burden.

Insurance requirements: Commercially insured, Medicare / Medicaid, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

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: Yes

•Activation Required: No

Program Details

•REENROLLMENTS ONLY

•Patients may only qualify for assistance if reenrolling into the PAP and meet the eligibility requirements

•Patients who do not have health or prescription insurance and meet income restrictions may qualify to receive PRALUENT free of charge for up to 12 months

•Patients who have Medicare Part D insurance must provide proof of having spent over $500 OOP

•Patients can enroll online, or enrollment form can be downloaded from https://www.praluent.com/pdfs/PAPEnrollmentFormDIGITAL.pdf and faxed to 8448557278

•Program will also look for other coverage options that may help patients with their outofpocket costs for PRALUENT

•Eligible patients subject to program restrictions; all patients are subject to a soft credit check prior to approval, and proof of income may be required

•Eligible patients may submit for renewal

Enrollment Forms

Enrollment Form