Tezspire Together Co-pay Program

Funded

About

The Tezspire Together Co-pay Program offers substantial cost-saving benefits for eligible patients prescribed Tezspire medication. Under this program, patients can pay as little as $0 per dose of Tezspire and receive up to $100 per month for administration costs, highlighting the program's financial support. With a maximum annual benefit of $13,000 for medication and additional coverage for administration, the Tezspire Together Co-pay Program provides significant assistance, especially for those with commercial insurance within the United States, Puerto Rico, and US territories.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$13000 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: No

Program Details

•Patients may pay as little as $0 for each dose of TEZSPIRE medication, and they may also receive up to $100 per month for outofpocket costs for inoffice administration of TEZSPIRE

•Maximum benefit of up to $13,000 per calendar year for medication and up to $1,200 for administration costs

•The CoPay Card does not cover any other costs related to office visits

•Patients are responsible for all administration costs that exceed this amount

•Patients who are residents of Massachusetts or Rhode Island are not eligible for injection administration support

•The Patient Total Program Benefit may be less than the Maximum Program Benefit, depending on the patient’s plan; may vary among individual patients covered by different plans

•Program coverage through the TEZSPIRE CoPay Card is contingent on the submission of the required Explanation of Benefits (EOB) form (where applicable) within 180 days of the date of service

•Benefits reset each calendar year

•Reenrollment in the program is required at regular intervals

•Patients may participate in the program as long as s/he reenrolls as required by Amgen and AstraZeneca and s/he continues to meet all the program’s eligibility requirements during participation in the program

•For more information patients can call 8888977473, Monday–Friday, 8 am–8 pm ET

Enrollment Forms

Enrollment Form