A·S·A·P Co-pay Program: Skytrofa

Funded

About

The A·S·A·P Co-pay Program: Skytrofa offers significant financial support for eligible patients requiring the Skytrofa medication. This program helps commercially insured patients lower their out-of-pocket expenses, allowing them to pay as little as $5 per monthly prescription with a maximum benefit of up to $6000 annually. The A·S·A·P Co-pay Program: Skytrofa is exclusive to patients with private insurance in the United States and territories and excludes those with state or federally funded insurance plans.

Insurance requirements: Commercially insured

As low as: $5 per mo

Enrollment Forms

Enrollment Form

Benefits

•$6000 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 $5 per monthly prescription

•Maximum benefit of up to $6000 per calendar year

•HCP should fax or email completed Statement of Medical Necessity Form to: (Fax) 8884360193 or (Email) info@ascendissupport.com

•For assistance or additional information, call 8444427236, Monday Friday, 8 AM to 8 PM ET

Enrollment Forms

Enrollment Form