Xywav Coupon Program

Funded

About

The Xywav Coupon Program offers significant savings for patients prescribed the drug Xywav. This program allows eligible patients to pay as little as $5 for a 30-day fill, making important medications more accessible. The Xywav Coupon Program is specifically for those with commercial insurance, ensuring that out-of-pocket expenses are minimized. This initiative, linked with the XYWAV REMS program, ensures affordability while maintaining safety standards.

Insurance requirements: Commercially insured

As low as: $5 per fill

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients can pay as little as $5 for XYWAV for a 30day fill, subject to monthly and annual maximum benefit

•Commercial insurance only; valid for outofpocket expenses, including copay/coinsurance/plan deductibles exceeding $5 (for XYWAV) per 30day prescription fill

•The Coupon Program is for patients enrolled in the XYWAV REMS program

•For more information call 18335335299 MondayFriday, 8 AM8 PM ET

•Fax completed Form to 18664701744

Enrollment Forms

Enrollment Form