Rezlidhia CoPay Assistance
Funded
About
Rezlidhia CoPay Assistance offers significant financial relief for patients prescribed Rezlidhia. This program allows eligible patients to pay as little as $15 per prescription fill, covering up to $25,000 annually, making Rezlidhia more accessible for those with commercial insurance. Rezlidhia CoPay Assistance is not available for state or federally funded insurance plan members, cash-paying patients, or those ineligible states. Patients must reapply annually for continued eligibility.
Insurance requirements: Commercially insured
As low as: $15 per fill
Enrollment Forms
Enrollment Form
Benefits
•$25000 annual maximum benefit
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Must be 18 years of age or older
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: No
•Activation Required: Yes
Program Details
•Eligible commercially insured patients may pay as little as $15 per prescription fill for REZLIDHIA
•The patient will be responsible for any outofpocket expenses after the $25,000 annual cap
•Patient must reapply for program eligibility at the end of each calendar year
•Patient and prescriber should fill out enrollment form and fax to 8333974435
•For assistance or additional information, call 8337443562, Monday to Friday, 8am to 8pm EST
Enrollment Forms
Enrollment Form