Contact info
- Phone
- 1-844-826-8371
- Fax
- 1-800-214-7295
Eligibility
- Patient must not have prescription coverage for needed medication.
- Patients with Medicare Part D should contact the program for eligibility.
- Program offers Co-pay assistance, reimbursement support, and patient assistance programs are available for eligible patients.
- Applications can be faxed or emailed to CoverOne@emdserono.com.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Yes
- US citizenship or residency required
- Yes
Not sure where your income falls? See this year's federal poverty guidelines (opens in a new tab).
Application process
- Documents to attach
- Proof of income
- Prescription
- Prescriber license number
- NPI number
- State license number
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Provider and patient
Getting the medication
- Patient receives
- Medication
- Shipped to
- Provider
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- New application every 12 months
Medications covered
- Bavencio (avelumab injection)