#Lls copay assistance login free#
This offer cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified medicine.
You must deduct the value received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf. Enrolled patients are responsible for all co-pays and any other balances not covered by the CoverOne co-pay assistance program. CoverOne may provide co-pay assistance to eligible Bavencio patients up to $30,000 per calendar year. This offer is not valid for medicines that are eligible to be reimbursed this private insurance plans or other health or pharmacy benefit programs, which reimburse you for the entire cost of your prescription drugs. If your insurance status changes, you must notify us immediately. The offer is not valid for medicines that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico ). The CoverOne Co-pay program is offered to eligible BAVENCIO (avelumab) Injection patients who are insured through a private/commercial health plan, and are enrolled in CoverOne. The co-pay program does not assist with inpatient hospital claims, or in any bundled payment arrangement where there is no separate patient co-pay for BAVENCIO, and does not assist with healthcare premiums or drug administration services.īy enrolling in the CoverOne co-pay program, you acknowledge that you currently meet the eligibility criteria and will comply with the Terms and Conditions described below: The patient co-pay assistance program is not contingent on any past or commercial sale of BAVENCIO. To learn more, call 1-87 (Monday–Friday 8 AM–8 PM ET) or visit Pfizer Oncology Together. Pfizer Oncology Together TM provides personalized support and financial assistance resources to help patients access their prescribed axitinib. When BAVENCIO is used in combination with axitinib, questions related to reimbursement and access for axitinib may be referred to Pfizer Oncology Together TM. CoverOne Address: PO Box 29293, Phoenix, AZ 85038-9293, CoverOne toll-free phone number: 844-8COVER1 (84). Once the annual co-pay assistance limit is reached, enrolled patients are responsible for paying all co-pays and any balance not covered by CoverOne. Enrolled patients may be eligible to pay as little as a $0 co-pay for each treatment for Bavencio, up to a maximum of $30,000 per year. 
Eligible co-pay expenses must be in connection with a separately paid claim for BAVENCIO ® administered in outpatient setting, which is otherwise covered by a private/commercial insurance plan. Whether an expense is eligible for the CoverOne Co-Pay Assistance benefit will be determined at the time the benefit is paid. Enrollment in the co–pay assistance program does not guarantee assistance.We are not permitted to offer CoverOne Co-pay Assistance to any claims covered, paid or reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs.HCPs may submit an application for co-pay assistance for their privately-insured patients by submitting an enrolment form through the CoverOne Enrollment Portal or by faxing a completed Enrollment Form to 1-80.Limits, terms and conditions apply, see below CoverOne provides co-pay assistance for privately-insured BAVENCIO ® (avelumab) 20mg/mL patients with co-pay/co-insurance responsibilities who meet the program eligibility criteria.
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