Programas de asistencia al paciente para Cimzia

Solicite apoyo para su receta con Cimzia

Si califica, los programas a continuación le pueden ser útiles para conseguir Cimzia. Revise la información para saber si califica. Las solicitudes están disponibles en formato PDF y deben enviarse directamente a quien proporciona el programa de asistencia al paciente.

Si tiene alguna pregunta favor de comunicarse al teléfono para el programa correspondiente (no PharmacyChecker.com), o vaya a la página del programa.

¿Está buscando otro tipo de medicamento?

Patient Access Network Foundation (PAN)

(Programa 1 de 2 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: Patient Access Network Foundation
None
TEL: 866-316-7263
FAX: 866-316-7261
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Cimzia (certolizumab pegol)
Requisitos de Elegibilidad
  • Insurance Status *See Additional Information section below
  • Those with Part D Elibible? Determined case by case
  • Income Between 400-500% of FPL
  • Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
  • U.S. Residency Required? Must reside and receive treatment in US
Solicitud
  • Obtaining Call or complete online
  • Receiving Complete online or by phone
  • Returning Complete online or by phone
  • Doctor's Action Will be discussed with patient and Doctor after request is received
  • Applicant's Action Call for information or inform doctor that he/she is in need
  • Decision Communicated Patient and Doctor notified in writing
  • Decision Timeframe Within 48 hours
Medicamento
  • Amount/Supply Not applicable
  • Sent To Patient sent card to be used at pharmacy
  • Delivery Time Once approved; shipped same day
  • Refill Proces Patient presents voucher/card to pharmacy for each refill
  • Limit None
  • Re-application New application every 12 months
Información Adicional
*Patients must have health insurance and their insurance must cover the qualifying medication for which they seek assistance. Call 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. Note: All new enrollment is now done electronically or over the phone. Contact program for details.
Actualizado August 6, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

Volver al principio

UCBCares Program

(Programa 2 de 2 — Para visualizar todos, deberá desplazarse hacia abajo )

Provienen de: UCB, Inc.
1330 Enclave Parkway Suite 125 Houston, TX 77077
TEL: 844-599-2273
ALT PHONE: 844-599-2273
FAX: 855-880-5262
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • Cimzia (certolizumab pegol)
Requisitos de Elegibilidad
  • Insurance Status Uninsured or Underinsured with no prescription coverage
  • Those with Part D Elibible? Determined case by case
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? Must reside in the US, District of Columbia, or Puerto Rico and have a prescription from a U.S. licensed doctor.
Solicitud
  • Obtaining Call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application should be faxed back from the doctor's office.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient notified
  • Decision Timeframe Not specified
Medicamento
  • Amount/Supply Amount requested is sent
  • Sent To Patient's home, unless otherwise noted
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Once a year new application required. Financial documentation may be requested any time
Información Adicional
This program also provides copay assistance.
Actualizado July 30, 2019

Si usted, su paciente o un ser querido no es elegible para este programa o otros, se pueden encontrar precios de aquí.

Volver al principio