Patient Assistance Programs

: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Gelsyn-3. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Bioventus Patient Assistance Program

(Program of 1 — Scroll down to see them all )

Provided by: Bioventus LLC
Bioventus Active Healing Therapies 4721 Emperor Blvd. Suite 100 Durham, NC 27703
TEL: 800-396-4325
FAX: 866-832-7284
Languages Spoken:
English
Program Website
Medications
  • Gelsyn-3 (sodium hyaluronate)
Eligibility Requirements
  • Insurance Status Determined case by case
  • Those with Part D Elibible? Not specified
  • Income At or below 250% of FPL
  • Diagnosis/Medical Criteria Medically Necessary as determined by a Doctor
  • U.S. Residency Required? The patient must also be under treatment from a US doctor.
Application
  • Obtaining Call or download
  • Receiving Faxed to Doctor's office
  • Returning Email or fax
  • Doctor's Action Complete section and sign
  • Applicant's Action Inform Doctor that he/she is in need
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medication
  • Amount/Supply Amount requested is sent
  • Sent To Doctor's office or specific site
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Not specified
Additional Information
Resources for HEALTHCARE PROFESSIONALS ONLY.
Updated October 5, 2018

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