Enzyvant CONNECT® Commercial Co-Pay Program Eligibility Guidelines

Patient must be fully enrolled in Enzyvant CONNECT® Patient Support Program.

Once Enzyvant CONNECT completes the Benefits Investigation, they will determine eligibility for the co-pay program in accordance with the guidelines and criteria.

• Only commercially insured patients (no federal or state healthcare program, including Medicare, Medicaid, TRICARE, DoD, or any state medical or pharmaceutical assistance program) are eligible
• Only valid in the United States and US territories (Puerto Rico and US Virgin Islands); this offer is void where prohibited by law, taxed, or restricted
  • California and Massachusetts legislation restricts if a generic equivalent is available
• The co-pay program is for assistance with the product’s out-of-pocket expenses only
  • No ancillary support (ex: administration, office visits/valuations, blood work, X-rays or other testing, pre-medications/other medication) will be covered
    • Assistance requires that commercial insurance reimburse the product separately (and charge a product coinsurance separately)
  • Insurance cannot cover the entire cost of the prescription
• Self-pay patients are not eligible
• Approval is based on calendar year (01/01-12/31)
• Must have commercial payer approval for the product

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