*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance.Ĭall for most recent medications as the list is subject to change and the medication for which you are seeking assistance must treat the disease directly. Doctors action will be discussed with the patient and doctor after the request is received. Patients must call for information or inform their doctor that they are in need. Patients or healthcare providers can complete the application online or by phone. Patients must be at or below 400-500% of the federal poverty level, must have a medically appropriate diagnosis/condition and must reside and receive treatment in the US. Patient with Medicare Part D will be considered on a case by case basis. The patient's insurance must cover the qualifying medication that they are seeking assistance for. This is a copay assistance program for patients that have health insurance. This program also provides co-pay, reimbursement assistance and adherence support. *Patients are subject to audit and must provide financial documentation. Medication will be shipped to the patient's home within 1 week of receiving prescription. Patient must re-enroll at the end of every calendar year. Patient will be contacted by the company to arrange refills. Income requirements not disclosed at this time. The patient will be given a decision over the phone during the screening process. The patient responds to questions over the phone to verify eligibility. Provider must call for application & fax in the prescription. Patient must reside permanently in the US or US territories. Insurance requirements are determined on a case by case basis, this includes Medicare part D patient's. NOTE: Linked drugs are available for Prescribers to Apply Online now.Ĭlick drug logo or drug name to start online application.
Applications can be completed online or Prescription, Demographics and Proof of Income may be faxed to 81 Attn: Dorrie
#Otezla copay card full
Once approved medication is shipped to Patient's home within 2 business days.ĭiplomat Specialty Pharmacy is a full service pharmacy that can help patients seek funding assistance for the copay portion of their required medications. Re-applications are determined case by case. Company contacts patient to arrange refills, refill limit varies. Patient and/or Doctor are notified of decision within 1-2 business days.Īmount requested is sent.
Proof of income may be requested by program at any time. Patient must complete application, sign and provide annual income information. Application is to be mailed or faxed back to company.ĭoctor's action will be discussed with patient and Doctor after request is received. Patient or Doctor may call to receive application via fax or mail. Must have medically appropriate condition/diagnosis. Income requirements determined case by case. Medicare Part D patients are eligible for this program. Diplomat's Co-Pay Assistance Navigator Program
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