Qinlock Bridge Program
Funded
About
The Qinlock Bridge Program offers significant benefits for patients prescribed Qinlock, providing support during coverage lapses. Patients can maintain access to their medication with a temporary supply, ensuring uninterrupted treatment. This comprehensive program, called the Qinlock Bridge Program, is specifically designed to assist those with private or government insurance in the United States and US Territories.
Insurance requirements: Commercially insured, Medicare / Medicaid, Underinsured
Enrollment Forms
Enrollment Form
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: No
•Activation Required: No
Program Details
•Eligible patients experiencing a lapse in coverage may be eligible for a temporary supply of their medication
•Eligible patients may receive a 10day supply with up to 5 refills
•HCP should fax completed enrollment form to 8333274329
•For assistance or additional information, call 8334322237 (Monday–Friday 8AM–8PM ET) or email info@decipheraaccesspoint.com
Enrollment Forms
Enrollment Form