Merck Patient Assistance Program: Prevymis

Funded

About

The Merck Patient Assistance Program: Prevymis is an exceptional initiative aimed at providing free access to the drug Prevymis for eligible patients. Designed primarily for uninsured U.S. residents with a prescription, the program also considers insured individuals facing financial challenges, provided they meet the set income criteria. Through this program, Merck ensures that patients can receive necessary medication at no cost, fostering better health and well-being.

Insurance requirements: Underinsured, Uninsured

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

•Eligible patients receive medication free of charge

•HCP and patient should complete the enrollment form and fax to 8668664127, or mail to The Merck Access Program, PO Box 2349, Columbus, OH 43216

•Enrollment is good for 12 months from the date of approval; patients must submit a new application yearly to reenroll

•Call 8554045278, Monday Friday, 8am8pm ET for more information

Enrollment Forms

Enrollment Form

Other Programs

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Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $4400/year*

Merck Access Co-pay Assistance: Prevymis

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $2500/year*

Pay as low as

$15/ fill

Other Tools for Prevymis

Check medication interactions

Get prior authorization forms

Get patient education materials