Merck Patient Assistance Program: Welireg

Funded

About

The Merck Patient Assistance Program: Welireg offers significant benefits by providing the medication Welireg free of charge to eligible patients. This program is designed to support U.S. residents, including those in U.S. Territories, who have been prescribed a Merck product and meet specific financial criteria. The Merck Patient Assistance Program: Welireg ensures access to necessary treatments for both uninsured individuals and those who face financial barriers despite having insurance.

Insurance requirements: 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 receive medication free of charge

•Enrollment form can be downloaded from the website, or enrollment can be completed online

•Completed enrollment forms can be faxed to 18557550518, or mailed to The Merck Access Program, PO Box 2349, Columbus, OH 43216

Enrollment Forms

Enrollment Form