Contact info
- Phone
- 1-888-727-3782
- Fax
- 1-800-621-5203
- Mailing address
- 215 First StreetCambridge, MA 02142
Eligibility
- Patient must be uninsured or rendered uninsured.
- Program provides co-payment and patient assistance programs for eligible patients.
- 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
- Not published
- Prescriber license number
- NPI number
- Both DEA and state license numbers
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Provider and patient
Getting the medication
- Patient receives
- Not published
- Shipped to
- Provider
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- Not published
Medications covered
- Amondys 45 (casimersen injection)
- Elevidys (delandistrogene moxeparvovec-rokl)
- Exondys 51 (eteplirsen injection)
- Vyondys 53 (golodirsen injection)