JazzCares Copay Program: Zepzelca

Funded

About

The JazzCares Copay Program for Zepzelca offers significant financial assistance to eligible commercially insured patients, helping them manage out-of-pocket costs for the drug Zepzelca. This program ensures that patients can access their medication with potentially minimal copayments, facilitating better adherence to treatment protocols prescribed by healthcare providers.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Program Requirements

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible commercially insured patients may qualify for assistance with outofpocket costs for Zepzelca, subject to an annual maximum

•Patients may pay as little as $10 copay

•HCP and patient must complete form to 18555933955 OR mail to JazzCares Program, PO Box 5490, Louisville, KY 40255 OR complete the enrollment electronically through https://www.jazzcares.com/patients/zepzelca

•Must provide a copy of the patients front and back of insurance card

•For more information patients must call JazzCares toll free at 18335335299, MondayFriday, 8 am to 8 pm ET

Enrollment Forms

Enrollment Form