Onzetra xsail Prescription Assistance Programs

Onzetra xsail: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Onzetra Xsail. 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?

Advanced Patient Services (APS) Program

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

Provided by: Avanir Pharmaceuticals, Inc.
PO Box 42886 Cincinnati, OH 45242
TEL: 877-884-4003
FAX: 877-788-4943
Languages Spoken:
English, Others By Translation Service
Program Website
Medications
  • Onzetra Xsail (sumatriptan)
Eligibility Requirements
  • Insurance Status Must be uninsured or underinsured
  • Those with Part D Elibible? Varies
  • Income At or below 200% of FPL
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? Must be a legal resident of the United States or its territories
Application
  • Obtaining Call or download
  • Receiving Faxed or mailed
  • Returning The completed application can be faxed or mailed back.
  • Doctor's Action Complete section, sign, attach required documents
  • Applicant's Action Complete section, sign, attach required documents
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Varies
Medication
  • Amount/Supply Up to 90 day supply
  • Sent To Doctor's office
  • Delivery Time Within 3-5 business days
  • Refill Proces Doctor/Doctor's office must contact the Program
  • Limit One year
  • Re-application New application every 12 months
Additional Information
This program also provides co-pay and reimbursement assistance. Please visit www.Nuedexta.com (855-468-3339) & www.Onzetra.com (844-669-3872) for more information.
Updated May 16, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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