BRISTOL-MYERS SQUIBB
Bristol-Myers Squibb Patient Assistance Foundation Inc.
Information last checked June 26, 2026
Contact info
- Phone
- 1-800-736-0003
- Fax
- 1-800-736-1611
- Mailing address
- PO Box 220769Charlotte, NC 28222-0769
Eligibility
- Patient must not have insurance coverage and is being treated as an outpatient for one of the medications listed on application.
- Patients with Medicare Part D must have spent at least 3% of yearly household income on out-of-pocket costs for prescriptions this year.
- 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
- 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
- Amount varies
- Time to first delivery
- 0–2 weeks
- Refills
- The patient or doctor must contact the company for refills.
- Staying enrolled
- New application every 12 months
- New proof of income every 12 months
Medications covered
- Camzyos (mavacamten)
- Cobenfy (xanomeline and trospium chloride)
- Eliquis (apixaban)
- Nulojix (belatacept)
- Orencia (abatacept)
- Sotyktu (deucravacitinib)
- Zeposia (ozanimod capsule)