Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
 

Velphoro

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Velphoro Access Solutions

This program provides brand name medications at no or low cost

Provided by: Fresenius Pharmaceuticals


TEL: 877-774-6756


FAX: 866-496-8638
Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

Fresenius Pharmaceuticals Program Application for Benefit Investigation (Velphoro)

 

Medications

  • Velphoro tablet; chewable (sucroferric oxyhydroxide)
 

Eligibility Requirements   

Insurance Status Contact program for details.
Those with Part D Eligible? Contact program for details.
Income Not disclosed
Diagnosis/Medical Criteria Must be on dialysis
US Residency Required? Must be US citizen or permanent resident residing in the US or US territories and treated by a US licensed doctor.
   

Application

Obtaining Call or download
Receiving Faxed or mailed
Returning Fax
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe Not specified
   

Medication

Amount/Supply Contact the program for more details.
Sent To Patient's home
Delivery Time Contact Program for Details
Refill Process Contact program for details.
Limit Contact the program for details
Re-application Contact program for details.
   

Additional Information

This program also provides copay assistance.

Updated February 16, 2021