ViiVConnect Patient Assistance Program: Oral Medications

Funded

About

The ViiVConnect Patient Assistance Program: Oral Medications offers significant benefits by providing eligible patients with access to life-saving medications such as Epivir, Retrovir, Selzentry, Tivicay, and others at no cost. This program is particularly beneficial for those who are uninsured or have specific Medicare plans, ensuring they receive the necessary drugs without financial burden.

Insurance requirements: 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 may be able to receive medication free of charge

•Submit the completed application and any applicable documentation via fax to 8442087676 or upload to the ViiVConnect Provider Portal at ViiVConnectPortal.com

•For assistance or additional information, call 8445883288, Monday through Friday, 8 am to 11 pm ET

Enrollment Forms

Enrollment Form