Programas de asistencia al paciente para Nulojix

Solicite apoyo para su receta con Nulojix

Si califica, los programas a continuación le pueden ser útiles para conseguir Nulojix. 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.

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Bristol-Myers Squibb Patient Assistance Foundation

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

Provienen de: Bristol-Myers Squibb Company
PO Box 220769 Charlotte, NC 28222-0769
TEL: 800-736-0003
FAX: 800-736-1611
Idiomas hablados:
English, Spanish, Others By Translation Service
La Página del Programa
Medicamentos
  • Nulojix (belatacept)
Requisitos de Elegibilidad
  • Insurance Status Must have no prescription coverage
  • Those with Part D Elibible? Considered on exception basis
  • Income At or below 300% of FPL
  • Diagnosis/Medical Criteria Medication must be for outpatient use only
  • U.S. Residency Required? The patient must reside in the US, Puerto Rico or the USVI.
Solicitud
  • Obtaining Call or download
  • Receiving Faxed
  • Returning The completed application can be faxed or mailed back.
  • Doctor's Action Complete section and sign
  • Applicant's Action Complete section, sign, attach a copy of proof of income
  • Decision Communicated Patient and Doctor notified in writing
  • Decision Timeframe Within a week
Medicamento
  • Amount/Supply Varies
  • Sent To Doctor's office
  • Delivery Time Within 5-7 business days
  • Refill Proces Doctor/Doctor's office must contact company
  • Limit None
  • Re-application New application yearly
Información Adicional
Co-payment assistance and patient assistance programs are available for eligible patients.
Actualizado May 28, 2019

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

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BMS Access Support (Kidney Transplant)

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

Provienen de: Bristol-Myers Squibb Company
Kidney Transplant Reimbursement Support PO Box 221509 Charlotte, NC 28222-1509
TEL: 800-861-0048
FAX: 888-776-2370
Idiomas hablados:
English, Others By Translation Service
La Página del Programa
Medicamentos
  • Nulojix (belatacept)
Requisitos de Elegibilidad
  • Insurance Status Contact program for details.
  • Those with Part D Elibible? Contact program for details.
  • Income Not disclosed
  • Diagnosis/Medical Criteria Varies
  • U.S. Residency Required? Must be residing in the US or Puerto Rico
Solicitud
  • Obtaining Call or download
  • Receiving Downloaded from website
  • Returning The completed application must be faxed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Doctor notified
  • Decision Timeframe 2 business days, once application process is complete
Medicamento
  • Amount/Supply Contact the program for more details.
  • Sent To Varies
  • Delivery Time Not specified
  • Refill Proces Contact program for details.
  • Limit Varies
  • Re-application Must re-enroll at end of calendar year
Información Adicional
This program also provides copay assistance. Absent a change in Massachusetts law, effective July 1, 2019, Massachusetts residents will no longer be able to participate in this Program.
Actualizado May 7, 2019

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

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