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