Program Details
Sanofi and Regeneron Pharmaceuticals, Inc.
KevzaraConnect
Kevzara
(sarilumab)
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CONTACT
INFO |
|
Address: |
, |
Phone: |
1-844-538-9272 |
Provider Phone: |
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Fax: |
1-844-538-8960 |
Website: |
Program Website |
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ELIGIBILITY
|
|
Eligibility
Info: |
Contact program for details.
This program provides KEVZARA at no cost for up to 12 months to eligible uninsured, underinsured, and certain Medicare Part D patients if additional eligibility requirements are met.
This program also provides co-pay assistance.
|
|
Couple |
|
% FPL |
Income at or below: |
Not
Published |
Medical expenses
can be deducted from reported income: |
Not
Published |
Social security requested on form: |
No |
US citizenship/residency specified:
|
Yes |
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APPLICATION |
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Attachments
Required: |
Not Published
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Physician
License #
Required: |
State
NPI
|
Prescriber
Signature
Allowed: |
Physician
|
Application
may be
faxed: |
Yes
|
Eligibility
determination
letter sent: |
Provider
|
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MEDICATION |
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Receives: |
Varies
|
Shipped To: |
Patient
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Quantity in
Shipment: |
Not Published
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Delivery Time: |
Not Published
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Re-application
Policy: |
Not Published |
Refill Policy: |
Not Published
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Other Information: |
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Last Updated: 02/26/2024
www.RxAssist.org
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