Vyleesi Copay Program

Funded

About

The Vyleesi Copay Program offers significant financial benefits for those prescribed Vyleesi, allowing eligible patients to pay as little as $0 for their copay. This program is designed to assist with copay, coinsurance, or deductibles, specifically supporting Vyleesi users who meet the individual eligibility criteria.

Insurance requirements: Commercially insured, Underinsured

Enrollment Forms

Enrollment Form

Program Requirements

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients may pay as little as $0 copay

•Financial assistance applies to the patient’s copay, coinsurance, or deductible for patients receiving Vyleesi

•Copay assistance will only apply to 2 fills every 30 days

•Enrollment into the program cannot be retroactive

•Each patient’s eligibility is evaluated on an individual basis

Enrollment Forms

Enrollment Form

Other Tools for Vyleesi

Check medication interactions

Get patient education materials