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Patient Assistance Portal

RESOURCES FOR FAMILIES IMPACTED BY COVID-19

In addition to the resources below, please see the Financial Assistance section on聽HFA’s Coronavirus (COVID-19) Resource Hub聽for resources specific to coronavirus impact. The Hub also contains resources on health, product availability concerns, mental wellness, and more.

Note: The programs and services listed below are independent of HFA and provided as a courtesy to our community. 聽HFA makes every attempt to provide accurate information. However, programs change frequently, so please contact the manufacturers or organizations directly to inquire about their programs.聽Charts updated 10/25/2019. 2020 updates coming soon!聽

SEE WHICH RESOURCE CHART FITS YOUR NEED, THEN CLICK THE BUTTON TO JUMP TO THAT SECTION.

NEW! Financial assistance resources including how to find local assistance, government benefits, dental care, diapers, food, grants, insurance help, medication assistance, medical items, medical travel, mental health crisis lines, and utility assistance. Click the button to see an easy-to-navigate PDF.

Additional Resources

Manufacturer Copay Assistance is useful for people who have insurance but need help with out-of-pocket costs for their bleeding disorder prescriptions. Click the button below to jump to the chart.

Hemophilia / vWD Manufacturer Copay Assistance

If you are uninsured, underinsured, or experiencing a lapse in insurance coverage, there are assistance programs to provide or navigate access to bleeding disorder prescription products. Click the button below to jump to the chart.

Hemophilia / vWD Manufacturer Product Assistance & Insurance Navigation

If you have Hepatitis C, consult this list of programs that provide free or reduced cost prescription products and co-payment assistance. For a quick reference of manufacturer assistance programs for Hepatitis C treatments, look up your medication on the聽HealthWell Foundation Resource List of product-specific programs. Click the button below to jump to a chart of resources.

Hepatitis C Copay & Product Assistance

Hemophilia/vWD Manufacturer Co-Pay Programs

Company/Organization Co-pay/Co-insurance

Program Name &

Contact Information

Limit Total Notes:
Aptevo聽Therapeutics IXINITY Savings Program

1-855-494-6489

$12,000 per year 鈥 Must have a valid prescription for IXINITY.

鈥 Must have commercial insurance.

鈥 No monthly limits unless limit total is reached.

鈥 No income requirements.

鈥 Co-pay program can be used retroactively for up to 12 months.

Bayer Bayer Access Services

1-800-288-8374

$12,000聽per year Product Copay Program

$250 per year Jivi Lab Monitoring

鈥 $0 CoPay Program for Kogenate, Kovaltry, and Jivi regardless of income.

鈥 Up to $250 in assistance per year toward out of pocket costs for laboratory monitoring of Jivi

鈥 Assistance is awarded per patient. Multiple members of the same household can apply.

鈥 Must have private/commercial insurance.

CSL Behring MyAccess Program

 

1-800-676-4266

$12,000聽per year

鈥 Must take a CSL Behring eligible product (on-label) for the treatment of von Willebrand disease or hemophilia, including Humate-P, Idelvion, or Afstyla.

鈥 Must currently have US-based private insurance that covers your therapy (federally funded program ineligible).

鈥 Contact My Source Care Coodinator at the number listed to enroll and to obtain further information about the program.

Program benefit DOES NOT apply toward out-of-pocket costs for:

鈥 Physician office visit co-pays.

鈥 Infusion-related costs or ancillary supplies.

鈥 Insurance premiums.

Genentech HEMLIBRA Co-Pay Program

1-844-436-2672

$15,000聽per year 鈥 No income requirements.

鈥 Your enrollment in the program is valid for up to 12 months (You may reapply at the end of 12 months).

鈥 The program covers the remaining part of your co-pay, up to $15,000 per year.

You may be eligible if you:

鈥 Have been prescribed HEMLIBRA for an FDA-approved indication.

鈥 Have commercial (private or nongovernmental) insurance. This includes plans available through state and federal health insurance marketplaces.

鈥 Are not a government beneficiary and/or participant in a federal or state-funded health insurance program (eg, Medicare, Medicare Advantage, Medigap, Medicaid, VA, DoD or TRICARE).

鈥 Do not reside in a state where the program is prohibited.

Grifols Factors for Health Copay Assistance Program

1-844-693-2286

(844-MY-FACTOR)

In-network claims will be approved up to out-of-pocket maximum.

Out-of-network聽may be denied by the program administrator.

鈥 Patients with commercial insurance may pay as little as $0 for ALPHANATE.

鈥 No monthly or annual maximums. Individual claims exceeding $2000 will be reviewed for network eligibility. Claims that are in-network will be approved, but those out-of-network may be denied.

鈥 Prescription is covered up to the patient鈥檚 annual out of pocket (OOP) maximum. The 2019 OOP maximum limits under the Affordable Care Act are $7,900 (self-only coverage) and $15,800 (coverage for more than self only).

鈥 Benefits investigation and support services help patients coordinate with their insurer.

Kedrion聽Biopharma 1-855-353-7466 N/A N/A
Novo聽Nordisk Co-pay Assistance聽Program

1-844-668-6732

(1-844-NOVOSEC)

$12,000 per year Apply online. Eligible individuals:

鈥 Have hemophilia A and have been prescribed an appropriate Novo Nordisk factor treatment; OR

鈥 Have congenital hemophilia A or B with an inhibitor, congenital FVII deficiency, Glanzmann鈥檚 thrombasthenia with refractoriness to platelet transfusions, or acquired hemophilia and have been prescribed an appropriate Novo Nordisk factor treatment; OR

鈥 Have FXIII A-subunit deficiency and have been prescribed an appropriate Novo Nordisk factor treatment; AND

鈥 Have private/commercial insurance only (state and federal funded programs ineligible)

Octapharma Octapharma Co-Pay聽Program

1-800-554-4440

Up to $12,000 per year NUWIQ CoPay Program

Wilate CoPay Program

鈥 Must be receiving treatment from Octapharma, or have a prescription to begin treatment.

鈥 Must have private/commercial insurance or self-pay.

鈥 Co-Pay Assistance Program does not cover costs associated with administration of therapy, such as office visits, infusion costs, or other professional services.

Pfizer Pfizer Factor Savings Card

1-888-240-9040

$12,000 per year 鈥 Register online to receive a Factor Savings Card or request one from your doctor, or call聽1-855-PFZ-HEMO (739-4366).

Provides co-pay and co-insurance assistance for a Pfizer factor product.

鈥 No financial eligibility requirements.

鈥 Must聽have private/commercial health insurance that covers factor.

Sanofi Genzyme (Formerly聽Bioverativ) ALPROLIX Co-pay Program

1-855-692-5776

ELOCTATE Co-payProgram

1-855-693-5628

$20,000聽per year 鈥 Available to those who use ALPROLIX or ELOCTATE.

鈥 Must have commercial insurance.

鈥 Must be treated by licensed doctor in US or Puerto Rico

鈥 Have a United States pharmacy.

鈥 Enrollment forms available via links provided

鈥 Not responsible for costs associated with administration of therapy, such as office visits, infusion costs, or other professional services.

Shire (now Takeda) Shire鈥檚聽Hematology Support Center CoPay Assistance Program

1-888-229-8379

$12,000 per year 鈥 For Advate, Adynovate, Feiba, Hemofil M, Recombinate, Rixubis, Vonvendi.

鈥 Must have commercial insurance. Not valid for prescriptions reimbursed, in whole or in part by Medicaid, Medicare, Medigap, VA, DoD, TRICARE or any other federal or state healthcare programs, including state pharmaceutical assistance programs, and where prohibited by health insurance provider or by law.

鈥⒙ Provides coverage for medication-related co-payment/co-insurance. Non-medication expenses, such as ancillary supplies or administration-related costs, are not eligible.

鈥 No income requirements.

鈥 Program is only valid for residents of the United States, excluding Puerto Rico and other U.S. territories.

Chart updated 10/25/2019. 2020 updates coming soon! Please call the listed number or visit the listed websites for the most up to date information.

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For those in the bleeding disorder community who are uninsured, underinsured, or experiencing lapses in insurance coverage, there are also assistance programs to help provide or navigate access to factor products.

Hemophilia/vWD聽Manufacturer Product聽Assistance聽and Insurance Navigation Programs

Company/Organization Product Assistance Program Name & Contact Information
Akorn聽Pharmaceuticals Patient Assistance Program: This needs-based program assists patients in accessing Amicar. Programs include copay assistance for patients with commercial insurance coverage and a need- based support program for those patients without commercial insurance. 1-844-202-5909
Aptevo Therapeutics IXINITY Patient Assistance Program: This program helps deliver treatment to those in need, even if they don’t have insurance. If you are uninsured or experience a lapse in your coverage, this program may cover you. 1-855-494-6489
Bayer Loyalty Program allows patients to earn points that can be redeemed for Bayer products (Kogenate FS,聽 Kovaltry, Jivi) in the event of a gap in insurance coverage or challenge with coverage. Patients with government insurance are not eligible. Enroll online or call聽1-800-288-8374.

Free Trial Program available for Kovaltry and Jivi.

Live Helpline Support is available to help with insurance coverage questions in multiple languages including Spanish.聽 1-800-288-8374

CSL Behring Patient Assistance Program: To be eligible, patients must be underinsured or uninsured. When enrolled, must actively be seeking insurance.聽1-844-PAP-CSLB (727-2752)

Assurance Program: Must currently have private health insurance coverage; this is a points program that allows current users to earn points that can be redeemed in the event of a future lapse in private health insurance coverage. 1-866-415-2164

CSL Behring My Source鈩 Hotline:聽Assistance navigating the complexities of insurance approvals, denials and appeals for patients with Coagulation disorders.聽1-800-676-4266

Genentech Genentech Patient Foundation provides free medicines to people who don’t have insurance or whose treatment is not covered by insurance (with income less than $150,000), or patients with insurance coverage who are struggling with high out-of-pocket costs and meet certain guidelines.聽 Call 866-422-2377 or see Genentech Access Solutions to find out your options.

HEMLIBRA Starter Program helps eligible patients taking HEMLIBRA receive free medicine while awaiting an insurance coverage determination.

Grifols Grifols Patient Assistance Program is for patients using ALPHANATE, AlphaNine SD or ProfilNINE who are uninsured or experiencing a temporary lapse of insurance coverage.

Grifols also has a Free Trial Program for eligible patients new to ALPHANATE and Care Coordination to help patients gain access to and remain on ALPHANATE.

1-844-MYFACTOR (1-844-693-2286)

Kedrion Biopharma 1-855-353-7466
Novo Nordisk Novo Nordisk Product Assistance Program: Provides medication to qualifying applicants at no charge. Eligible patients must have been prescribed a Novo Nordisk product for an indicated condition (check the website for a complete list of eligible conditions), have no prescription coverage, have a household income at or below 400% the federal poverty level. Patient must be a documented US resident or on a path to documented status with reasonable likelihood of attaining it. Federal government insurance programs are ineligible. 1-844-668-6732
Octapharma Reimbursement and Claims Support:聽Contact the Octapharma Support Center for help withreimbursement for your Wilate聽or NUWIQ prescription.聽Octapharma representatives are available to provide expert advice and information about insurance matters including individual claims processing reviews, assistance in appeals, insurance investigations into product coverage, and gaining approvals for prior authorizations for Wilate. 1-800-554-4440聽or usreimbursement@octapharma.com

NUWIQ Free Trial Program allows for up to six (6) doses, or 20,000 IUs, of NUWIQ. A prescription for NUWIQ is required and other restrictions may apply.

Wilate Free Trial Program allows for up to 5,000 IUs for Wilate. A prescription for Wilate is required and other restrictions may apply.

1-800-554-4440

Pfizer Pfizer Hemophilia Connect gives you easy one-stop access to Pfizer tools and programs.聽1.844.989.HEMO (4366)

Reimbursement Support聽services for eligible patients, including:

  • Benefit verifications
  • Prior authorization assistance
  • Appeals assistance
  • Claim denial review and research
  • Nurse-drafted appeals submitted directly to payer on Pfizer patient’s behalf
  • Timely status follow-up with the payer until the outcome is received

Pfizer Trial Prescription Program for patients with commercial insurance prescribed factor products for the first time.

Sanofi Genzyme (Formerly Bioverativ) Factor Access Program: Patients using ALPROLIX or ELOCTATE who have no prescription coverage, are facing a gap in coverage, or have reached their maximum insurance coverage limit, may be eligible to receive product for free. Those with federal or state government insurance are not eligible. Other restrictions may apply. See the enrollment form or contact the support line.

For ALPROLIX 1-855-692-5776 or

For ELOCTATE 1-855-693-5628

Shire (now Takeda) Shire’s Hematology Support Center helps educate on insurance options, navigate insurance access issues, and provide access to downloadable tools. Case Managers, Reimbursement and Access Managers, and Healthcare Educators are all part of the team. 888-229-8379

Chart updated 10/25/2019. 2020 updates coming soon! Please call the listed number or visit the listed website for the most up to date information.

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For a quick reference of manufacturers assistance programs for Hepatitis C treatments, look up your medication on HealthWell Foundation Resource List聽of product-specific programs.

Hepatitis C Virus Co-Pay & Patient Assistance Programs

Program Name & Contact Information Limit Total Notes:
AbbVie Assist

1-800-222-6885

Varies

 

鈥 myAbbVie Assist provides free AbbVie medicine to qualifying patients who:

  • Are being treated by a licensed U.S. healthcare provider on an outpatient basis and prescribed an AbbVie medicine that is included in our assistance program
  • Have limited or no health insurance coverage
  • Demonstrate qualifying financial need*
  • Live in the United States
*Financial need requirements vary by medicine, and are based on your insurance coverage, household income, and projected out-of-pocket medical expenses.

鈥 Assistance and eligibility varies by medicine. See this list to find out more.

鈥 If you qualify, you will receive free medicine for up to one year. At the end of your enrollment, you can re-apply for continued assistance.

The Assistance Fund聽

Hepatitis C Copay Fund

 

(855) 730-5873

Call to find out if the Hepatitis C Assistance Program is currently accepting new patients. Click here for to find out if you are eligible for each of the identified programs and here to see if the Hepatitis C fund is open.

鈥 Copay assistance if you need help paying for your portion of your prescription medication after insurance has paid its portion.

Bristol-Myers Squibb (BMS)聽

Patient Support CONNECT Co-pay Program

 

1-844-442-6663

For use of Daklinza up to a maximum benefit of $5,000 per 28-day supply of 30mg or 60mg OR up to a maximum benefit of $10,000 per 28-day supply of 90mg

 

鈥 You are insured by commercial insurance and your insurance coverage does not cover the full cost of your prescription (you have a co-pay)

鈥 You do not have prescription insurance coverage through a state or federal healthcare program, including but not limited to Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA) or Department of Defense (DOD) programs.

鈥 You are 18 years of age or older.

鈥 You are a resident of the US or Puerto Rico.

Gilead Co-pay Assistance

Harvoni Support Path

1-855-769-7284

 

The HARVONI Co- pay Coupon Program will cover the out-of-pocket costs of your HARVONI prescriptions up to a maximum of 25% of the catalog price of a 12-week regimen of HARVONI.

鈥 Eligible residents of the US, Puerto Rico, or US territories

鈥 Coupon not valid for prescriptions paid for in part or in full by any state- or federally funded program, including but not limited to Medicare or Medicaid, Medigap, VA, DOD, or TRICARE

鈥 You pay the first $5 per prescription fill.

鈥 The offer is valid for six (6) months from the time of first redemption.

Gilead

Support Path Patient Assistance Program

 

1-855-769-7284

 

Call for further details 鈥 Call to find out if you are eligible for help with聽Epclusa, Harvoni, Hepsera, Sovaldi,聽 or Vosevi.
Good Days

Chronic Disease Fund for Hepatitis C

 

1-877-968-7233

Up to $15,000 Good Days provides financial support for patients who cannot afford the treatment they urgently need. Complete the application online, by mail, or by fax.

Eligibility Criteria:
鈥 Patient must be diagnosed with Hepatitis C and program must be accepting enrollments
鈥 Patient must have a valid Social Security number to apply for assistance and receive treatment in the United States
鈥 Patient must be seeking assistance for a prescribed medication that is FDA approved to treat the covered diagnosis
鈥 Patient is required to have valid聽 Medicare or Military insurance coverage
鈥 Patient income level must be at or below 500% of the Federal Poverty Level (FPL)

Note: Program may open and close throughout the year depending on funding.

HealthWell Foundation

Hepatitis C Treatment Assistance

1-800-675-8416

 

Up to $30,000 鈥⒙ Assistance with the prescription drugs and biologics used in the treatment of Hepatitis C.

鈥 Must currently receive treatment for Hepatitis C (see webpage for list of treatments covered).

鈥 Must have insurance (private, federal, or state plans acceptable) that covers medication.

鈥 Assists individuals with incomes up to 500% of the Federal Poverty Level. Household number and cost of living in your area are also considered.

鈥 Must receive treatment in the US.

Patient Access Network (PAN) Foundation

Hepatitis C Treatment Assistance

1-866-316-7263

$7,000 per year 鈥 Financial assistance to financially and medically qualified patients, including those insured through federally administered health plans such as Medicare, 聽for co-payments, co-insurance and deductibles.

鈥 Patient must be getting treatment for Hepatitis C.

鈥 Patient must have health insurance that covers qualifying medication or product.

鈥 Patient鈥檚 medication must be listed on PAN鈥檚 list of covered medications (see website).

鈥 Patient must reside, and receive treatment in, the US. US citizenship is not a requirement.

鈥 Patient鈥檚 income must fall at or below 500% of Federal Poverty Level.

Patient Advocate Foundation

Co-pay Relief Hepatitis C Program

 

1-866-512-3861

$15,000 per year 鈥 Patient must be insured and insurance must cover the medication for which patient seeks assistance.

鈥 Patient must have a confirmed diagnosis of Hepatitis C.

鈥 Patient must reside and receive treatment in the United States.

鈥 Patient’s income must fall below 400% of the聽Federal Poverty Guideline聽 with consideration for cost of living and household size.

Chart updated 10/25/2019. 2020 updates coming soon! Please call the listed number or visit the listed websites for the most up to date information.

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