Recorlev Bridge Program

Funded

About

The Recorlev Bridge Program offers an incredible benefit for patients by providing Recorlev at no cost while they pursue insurance coverage. This program is designed specifically for those who have commercial insurance and a valid prescription for Recorlev, yet face denials due to prior authorization issues. The Recorlev Bridge Program makes accessing necessary medications simpler and more affordable for those who qualify.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients may receive Recorlev at no cost while pursuing insurance coverage

•Must have commercial insurance, a valid prescription for Recorlev, and a denial of insurance coverage based on a prior authorization request to qualify

•HCP and patient should fax completed Prescription Start Form and relevant medical documentation to 8669904540

•Call Xeris CareConnection at 8444447258, Monday through Friday from 8 AM to 7 PM ET for assistance or additional information

Enrollment Forms

Enrollment Form