Rezzayo Co-Pay Assistance

Funded

About

The Rezzayo Co-Pay Assistance program offers valuable support for patients prescribed the drug Rezzayo. This program provides co-pay assistance for commercially insured patients, potentially covering up to $400 per 200mg vial and $800 for a 400mg loading dose without any income requirement. Designed for eligible U.S. residents who are 18 years or older and receiving treatment in an outpatient setting, the Rezzayo Co-Pay Assistance program aims to alleviate financial burdens for those with valid prescriptions for FDA-approved indications whilst excluding anyone with government-funded prescription benefits.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

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: No

Program Details

•Eligible commercially insured patients may be able to receive CoPay support of up to $400/ 200mg vial, and up to $800/ 400MG loading dose with no out of pocket minimum

•There is no income requirement to qualify for the copay program

•HCP and patient should fax completed Patient Enrollment Form to 8888980033

•For assistance or additional information, call 8667399296, Monday through Friday, 8:30 am – 8:00 pm ET

Enrollment Forms

Enrollment Form