For US healthcare professionals
Monoferric Patient Solutions® Copay Assistance Program
Pharmacosmos Therapeutics understands that each patient’s financial circumstances are unique, which is why we offer copay assistance and other financial support to help them afford their treatment. You may check your patient’s eligibility for the Monoferric Patient Solutions Copay Assistance Program using www.monoferriccopay.com or while enrolling into Monoferric Patient Solutions.
Requirements to be eligible to participate in the Monoferric Patient Solutions Copay Assistance Program:
- Have commercial health insurance (i.e., health insurance offered through an employer; NOT Medicare, Medicare Advantage, Medicaid, TRICARE, or Veteran Affairs healthcare)
- Reside in the United States or Puerto Rico
- Be treated by a healthcare professional in the United States or Puerto Rico
- Be 18 years of age or older
- Be prescribed Monoferric for an on‑label diagnosis
Eligible patients will receive savings on out-of-pocket (OOP) expenses (i.e., deductible, copay, or coinsurance obligations) for Monoferric of up to $2000 per dose.a
Copay assistance may be applied retroactively to prescription costs that occurred within 120 days prior to the date of enrollment if the patient met all of the eligibility criteria at the time of the infusion.
Download the Monoferric Patient Solutions Copay Assistance Program Flashcard
Additional resources for starting patients on Monoferric
The Monoferric Patient Solutions Patient Assistance Program for patients who are underinsured or uninsured
The Monoferric Patient Solutions Patient Assistance Program is a program to help those people who are underinsured or uninsured with access to Monoferric.
Eligibility criteria
Patients must- Fall within the income guidelinesb
- Be uninsured or underinsured (Patients with claims covered, paid, or reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs are not eligible for this program)
- Be aged 18 years or older
- Be prescribed Monoferric for an on-label diagnosis
- Be a resident of the United States (residency includes anyone who lives in one of the US states, the District of Columbia, Puerto Rico, and US Virgin Islands). Citizenship or legal status is not a requirement
Previous
| a | If IDA returns within the coverage period, you would receive an annual maximum savings on OOP expenses of up to $4,000. Additional restrictions apply. Please see full Terms and Conditions. |
| b | Total household income is at or below 300% of the federal poverty level (FPL). Visit https://aspe.hhs.gov/poverty-guidelines, which lists the current FPL guidelines. Pharmacosmos Therapeutics Inc. and its authorized third-party agents will use the patient’s date of birth or social security number and/or additional demographic information as needed to access credit information and information derived from public and other sources to estimate income in conjunction with the eligibility determination process. As a soft credit inquiry, this option will not impact credit scores. Pharmacosmos Therapeutics Inc. and its authorized third-party agents reserve the right to ask for additional documents and information at any time. Note: Patients may retroactively qualify for assistance under the Patient Assistance Program if the patient’s healthcare provider submits an explanation of benefits (EOB) statement from the patient’s commercial insurance provider within 120 days of the date of service. |
