Velsipity Copay Savings Program - Covered benefit

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About

The Velsipity Copay Savings Program - Covered benefit provides significant financial assistance for patients prescribed Velsipity, allowing eligible participants to pay as little as $0 out-of-pocket for each qualifying prescription. With a generous maximum benefit of $16,000 per calendar year, this program is designed to make Velsipity more accessible to those with commercial insurance whose plans do not fully cover their medication costs. Velsipity Copay Savings Program offers a seamless support experience, ensuring patients have access to important prescreening tests and additional patient support services when enrolled in the VelsipityForMe program.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$16000 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: Yes

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients may pay as little as $0 outofpocket for each qualifying prescription

•Maximum benefit of $16,000 per calendar year

•To receive reimbursement for qualified outofpocket expenses, an Explanation of Benefits (EOB) form must be submitted, along with copies of receipts for any payments made

•Maximum saving limit applies; patient outofpocket expense may vary on a monthly, quarterly, and/or annual basis depending on each individual patient’s plan of insurance and other prescription drug costs

•Call 8003503080, MondayFriday, 8AM8PM ET, for assistance or additional information

•Pharmacists: call 8665626851, MF 8:00am to 8:00pm, for help processing the card

Enrollment Forms

Enrollment Form