Xipere Savings Program

Funded

About

The Xipere Savings Program offers significant financial benefits to eligible patients prescribed Xipere. With this program, commercially insured patients can potentially reduce their injection costs to as low as $0, up to a maximum savings of $6,000. The Xipere Savings Program is specifically tailored for patients with private insurance coverage, providing substantial savings and support for accessing their medications effectively.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$6000 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: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients may pay as little as $0 per injection, up to the program maximum, $6,000

•HCP should fax completed Patient Information and Enrollment Form to 8662728839

•For assistance or additional information, call 8662728838, MondayFriday, 9:00 AM5:00 PM, ET

Enrollment Forms

Enrollment Form