Contact info
- Phone
- 1-866-906-6100
- Fax
- 1-888-863-3361
Eligibility
- This program provides individual support for healthcare professionals and families throughout the Brineura treatment process.
- Contact program for details.
- Income limit, single
- Not published
- Income limit, couple
- Not published
- Medical expenses can be deducted
- Not published
- Social Security number asked for
- No
- 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
- Not required
- 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
- New application every 12 months
Medications covered
- Brineura (cerliponase alpa)
- Kuvan (sapropterin dihydrochloride)
- Naglazyme (galsulfase)
- Palynziq (pegvaliase-pqpz)
- Vimizim (elosulfase alfa)