Xcopri Free Trial Offer

Funded

About

The Xcopri Free Trial Offer provides eligible patients with access to a 28-day supply of Xcopri at no cost. Available in the US and Puerto Rico, this program is designed to help patients experience the benefits of Xcopri without financial burden. The Xcopri Free Trial is a valuable opportunity for those who meet the criteria, ensuring access to this essential drug product.

Insurance requirements: Commercially insured, Underinsured, Uninsured

Enrollment Forms

Enrollment Form

Benefits

•1 maximum fills per year

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: No

•Needs Based: No

•Activation Required: No

Program Details

•Dispense up to a 28day supply of product (in accordance with the prescription) at no cost to the patient

•Limit 1 offer per patient

•Trial offer program not offered in the state of Vermont

•For manual patient reimbursement, please submit the claim to ConnectiveRX by calling 18552263931

Enrollment Forms

Enrollment Form