Contact info
- Phone
- 1-833-828-6367
- Fax
- 1-866-312-4206
Eligibility
- Patient must complete enrollment form. Once patient enrollment form is submitted, if the patient is unable to access Tavneos after completing the prescription process, they may complete a Patient Assistance Program application and undergo screening by the Tavneos Team.
- Patient must be uninsured or unable to pay for medication.
- Program offers co-pay assistance, patient support, 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
- Not published
- 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
- Who can sign
- Physician
- Application can be faxed
- Yes
- Decision letter sent to
- Patient
Getting the medication
- Patient receives
- Medication
- Shipped to
- Patient
- Supply per shipment
- Not published
- Time to first delivery
- Not published
- Refills
- Not published
- Staying enrolled
- New application every 12 months
Medications covered
- Tavneos (avacopan)