EyePoint Assist Patient Support Program: Yutiq

Funded

About

The EyePoint Assist Patient Support Program: Yutiq offers comprehensive support services for patients prescribed Yutiq, including assistance with coordinating health insurance benefits and determining out-of-pocket costs. The program is designed to ensure that eligible patients in the United States who meet specific income criteria can access necessary treatments efficiently.

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

•Program will help with coordinating health insurance benefits, determining associated outofpocket costs, and assisting in determining eligibility for the YUTIQ patient assistance program

•Household income and number in household is required information for program approval

•Completed enrollment form should be faxed to: 18667833124, application will be reviewed, and an approval decision will be made within 5 business days

•Program does not include assistance for patient cost share for injection procedure or other costs associated with the administration of YUTIQ

Enrollment Forms

Enrollment Form