Xolair Co-pay Program

Funded
About
The Xolair Co-pay Program offers significant financial relief for those prescribed Xolair, enabling eligible commercially insured patients to potentially pay as little as $0 per treatment, with a maximum benefit of up to $15,000 annually. The program ensures affordability, making Xolair accessible for many patients while emphasizing automatic re-enrollment each year for continuous support.
Insurance requirements: Commercially insured
Enrollment Forms
Enrollment Form
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 could pay as little as $0 per treatment for Xolair; maximum benefit of up to $15,000 per calendar year
•Eligible patients may also pay as little as $0 per injection; maximum benefit of up to $1,500 per calendar year
•Once enrolled, program will not honor claims with date of service or medication dispensing that precede program enrollment by more than 180 days
•Claims must be submitted within 365 days from the date of service unless otherwise indicated
•The administration copay program is not valid for Massachusetts or Rhode Island residents
•For questions, call (855) 9652472 9 a.m.–8 p.m. ET, Monday through Friday