Recorlev Patient Assistance Program

Funded

About

The Recorlev Patient Assistance Program is designed to provide eligible patients with access to the drug Recorlev at no cost. By joining the Recorlev Patient Assistance Program, patients can receive free medication and benefit from guided support by healthcare professionals. The Recorlev Patient Assistance Program is committed to extending seamless assistance through the entire application and renewal process for those in need of Recorlev.

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

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Program provides eligible patients with free medication

•HCP and patient should fax completed Prescription Start Form and relevant 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