Rolvedon Copay Assistance Program - Covered benefit
Coverage RequiredNot Funded
About
The Rolvedon Copay Assistance Program - Covered benefit is designed to help eligible patients reduce their out-of-pocket expenses for the drug Rolvedon. This program is highly beneficial for those with commercial or private insurance, offering the potential for $0 copay per dose of Rolvedon, with a maximum annual benefit of $15,000. The program provides critical financial support to ensure access to Rolvedon for approved indications.
Insurance requirements: Commercially insured
Enrollment Forms
Enrollment Form
Benefits
•$15000 annual maximum benefit
•12 maximum fills per year
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: Yes
•Needs Based: No
•Activation Required: No
Program Details
•Patients with commercial or private insurance may pay $0 outofpocket costs for each ROLVEDON dose
•Must have a copay for Rolvedon
•Maximum annual benefit of $15,000 per 12month enrollment period
Enrollment Forms
Enrollment Form