Olumiant Savings Card - Non-covered benefit
Funded
About
The Olumiant Savings Card - Non-covered benefit program provides valuable financial assistance to patients prescribed Olumiant for an FDA-approved indication. Eligible participants may enjoy savings of up to $25 on a 30-day supply, significantly reducing out-of-pocket expenses. Designed for privately insured patients residing in the US and Puerto Rico, the Olumiant Savings Card enhances accessibility to this important medication.
Insurance requirements: Commercially insured, Underinsured
As low as: $25 per mo
Enrollment Forms
Olumiant Savings Card - Non-covered benefit
Benefits
•13 maximum fills per year
Program Requirements
•Valid only for residents in the US and Puerto Rico
•Must be 18 years of age or older
•Enrollment Required: Yes
•Coverage Required: No
•Needs Based: No
•Activation Required: Yes
Program Details
•Eligible commercially insured/not covered patients may be able to pay as little as $25 for each 30day supply
•Participation in the $25 program requires submission of a PA prior to the first prescription fill
•If coverage is denied, an appeal must be submitted prior to 5th month prescription fill; to remain eligible for the Program, a new PA, appeal, or medical exception must be submitted prior to the 13th prescription fill
•Card may be used for up to a maximum of 13 prescription fills per calendar year and up to a maximum of 24 prescription fills over the lifetime of the Program, subject to a maximum monthly and annual savings limit
Enrollment Forms
Enrollment Form
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