Rebyota Patient Assistance Program
Funded
About
The Rebyota Patient Assistance Program offers significant support by providing the drug product Rebyota at no cost to eligible uninsured and underinsured patients. The program ensures that patients with limited financial resources can access essential medication through a structured assistance scheme.
Insurance requirements: Commercially insured, 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 uninsured and underinsured patients may receive REBYOTA at no cost
•Note: PAP beneficiaries with government insurance are eligible to obtain medication through the end of the calendar year
•PAP beneficiaries with commercial insurance are eligible to obtain medication for up to 12 months
•Assistance is provided in the form of free product shipped to site of administration or reimbursement for the invoiced cost of the product if processed after product has been administered
•HCP and patient must complete form and fax to 18777787167
•For assistance call: 1877REBYOTA, MondayFriday 8 a.m. – 8 p.m. EST
Enrollment Forms
Enrollment Form