REACH4RYTELO Copay Program
Funded
About
The REACH4RYTELO Copay Program offers significant financial assistance for those prescribed Rytelo. By participating in the REACH4RYTELO Copay Program, eligible commercially insured patients can minimize their out-of-pocket costs, potentially reducing their expenses to as little as $0 for Rytelo, with an annual cap of $9,450. This program, designed specifically for Rytelo users, makes the medication more accessible by alleviating financial burdens.
Insurance requirements: Commercially insured
Enrollment Forms
Enrollment Form
Benefits
•$10650 annual maximum benefit
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: No
•Activation Required: No
Program Details
•Eligible commercially insured patients may pay as little as $0 out of pocket for Rytelo (including copay and coinsurance), up to $9,450 annually
•Eligible commercially insured patients may also save up to $100 per infusion, up to $1200 annually
•An itemized EOB must be provided with a separate line for the outofpocket cost of administration fee
•Residents of MA, MI, MN, and RI are not eligible to receive copay assistance for product administration and are therefore only eligible for a maximum benefit of $9450 per year for the cost of the drug
•HCP must submit completed enrollment form via fax: 8882242518 or email: Support@REACH4RYTELO.com
•Patients must be enrolled in REACH4RYTELO before enrolling in the Copay Program
•For assistance or additional information, call 8444798356, Monday to Friday 8:00 AM8:00 PM ET, excluding major holidays
Enrollment Forms
Enrollment Form