myAbbVie Assist: Qulipta, Ubrelvy

Funded

About

The myAbbVie Assist: Qulipta, Ubrelvy program offers substantial benefits for patients in need of Ubrelvy and Qulipta medications. This program is designed to assist individuals with limited or no health insurance coverage in accessing these critical drugs. Through the myAbbVie Assist program, eligible patients residing in the U.S. may receive their medication free of charge, ensuring they continue to manage their health effectively despite financial constraints.

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

•Completed AbbVie Patient Assistance Program forms should be signed by their HCP and faxed to: 8662502803

•Completed AbbVie PAP forms can also be mailed to: AbbVie Patient Access Support D617927 AP5 NE, 1 N. Waukegan Rd. North Chicago, Il 60064

•For assistance or additional information, call 8002226885, Monday Friday

Enrollment Forms

Enrollment Form

Other Programs

HealthWell: Migraine

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $4000/year*

PAF Co-Pay Relief: Migraine

Commercially Insured

Medicare / Medicaid

Underinsured

Uninsured

Max Saving: $2000/year*

Other Tools for Ubrelvy

Get prior authorization forms

Get patient education materials