Contact info
- Phone
- 1-844-454-5483
Eligibility
- Contact program for details.
- Program helps with benefits investigations, claims appeals information, and potential sources of support for eligible uninsured and underinsured patients. For eligible patients resources may include referrals to independent third-party nonprofit patient assistance programs.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- Not published
- US citizenship or residency required
- Not published
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
- Not published
- Who can sign
- Not published
- Application can be faxed
- Not published
- Decision letter sent to
- Not published
Getting the medication
- Patient receives
- Not published
- Shipped to
- Not published
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- Not published
Medications covered
- Tecartus (brexucabtagene autoleucel)
- Yescarta (axicabtagene ciloleucel)