Sanofi Patient Connection

Funded

About

The Sanofi Patient Connection program offers significant benefits by providing medications such as Elitek, Mozobil, Jevtana, Thyrogen, and Thymoglobulin free of charge to eligible patients. Patients must be U.S. residents under the care of a licensed healthcare provider and meet specific financial and insurance criteria. The program supports patients without insurance or those who cannot access prescribed treatments through their commercial insurance, ensuring they receive necessary medications for up to 12 months.

Insurance requirements: Commercially insured, Medicare / Medicaid, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Eligible patients receive medication free of charge for up to 12 months

•HCP and patients must complete the application form and submit application by fax: 18888471797 or mail: Sanofi Patient Connection, PO Box 222138, Charlotte, NC 282222138

•HCP can also submit completed application form through the Provider Portal (http://www.visitspconline.com/)

•Every patient receives a letter informing them of their eligibility

•Medicines are shipped directly to patient’s HCP in approximately 57 business days from when patient is approved

•Medicare Part D patients that qualify for assistance on an annual basis will be transitioned back to Medicare Part D at the beginning of each calendar year

•For more information, call 18888474877, MonFri, 9AM8PM ET

Enrollment Forms

Enrollment Form