The maximum Co-pay Assistance Program benefit per patient, per calendar year (January 1 through December 31), is $20,000. The benefit available under the Co-pay Assistance Program is limited to the amount the patient’s private health insurance company indicates on the Explanation of Benefits ("EOB") that the patient is obligated to pay for the Program Product, less $5, up to an annual maximum. Patient must pay the first $5 of co-pay per administration of Program Product.Claim for Program Product must be submitted by health care provider to patient’s private health insurance separately from other services and products. It is not valid for any other out-of-pocket costs (for example, office visit charges or medication administration charges) even if such costs are associated with the administration of the Program Product.
The benefit available under the Co-pay Assistance Program is valid for the patient’s out-of-pocket cost for the Program Product only. Patient must have an out-of-pocket cost for the Program Product and be administered the Program Product prior to the expiration date of the Co-pay Assistance Program.Subject to changes in state law, the Co-pay Assistance Program may become invalid for residents of Massachusetts prior to its expiration date.The Co-pay Assistance Program is not valid for uninsured patients. The Co-pay Assistance Program is not valid for patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange established by a state government or the federal government), Medicare, a Medicare Part D or Medicare Advantage plan (regardless of whether a specific prescription is covered), TRICARE, CHAMPUS, Puerto Rico Government Health Insurance Plan (“Health care Reform”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).Patient must have private health insurance that provides coverage for the cost of the Program Product under a medical benefit plan.Patient must be prescribed the Program Product for an FDA-approved indication.To receive benefits under the Co-pay Assistance Program for RENFLEXIS (“Program Product”), the patient must enroll in the Co-pay Assistance Program and be accepted as eligible.Terms and Conditions - RENFLEXIS - (Medical Benefit): Both sets of Terms and Conditions for the Co-pay Assistance Program for RENFLEXIS are set forth below. Co-pay and savings offers are for commercially insured patients only.The Organon Co-pay Assistance Program ("Co-pay Assistance Program") for RENFLEXIS consists of two sets of Terms of Conditions, one applicable to RENFLEXIS for which a claim is submitted by a patient’s health care provider (“Medical Benefit”) and the other applicable to RENFLEXIS purchased by a patient at a participating pharmacy (“Pharmacy Benefit”). †Terms, conditions and eligibility requirements apply. Sample eligibility is subject to change at any time.
After logging in, sample selections will appear based on eligibility. *Not all Pfizer products are available for sampling through this site. Speak with our Pfizer Connect customer experience team for assistance. View resources for you and your patients Example Videosįind videos and on-demand webinars Example PfizerPro Customer Service View resources for you and your patients Videosįind videos and on-demand webinars Eventsīrowse and register for speaker programs Example Materials Place orders for Hospital Products Order Now Explore Content Eventsīrowse and register for speaker programs Materials Pfizer provides prescription drug samples for select Pfizer products to eligible health care professionals for your patients Request Samplesĭownload available co-pay cards and patient savings offers across select Pfizer products View Offers Vaccines & Hospital Products View Products Order HCP & Patient Materialsįind resources for you and your patients Order Materials Samples* & Co-Pay Cards †
Request samples* or order select Pfizer products and find resources for you and your patients Browse Now Patient Assistanceįind available assistance programs View Options Pfizer Products
0 kommentar(er)
