| Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||
MyPraluent Patient Assistance Program (PAP)This program provides brand name medications at no or low cost |
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Provided by: Regeneron Pharmaceuticals, Inc. |
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PO Box 592188 TEL: 844-772-5836FAX: 844-855-7278 |
Languages Spoken:
English, Spanish |
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Program Applications and Forms |
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MyPraluent Patient Assistance Program (PAP) Enrollment Form |
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MyPraluent Electronic Enrollment |
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Medications |
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Eligibility Requirements |
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| Insurance Status | Must be uninsured or underinsured | ||
| Those with Part D Eligible? | Yes, but contact program for details | ||
| Income | At or below 300% of FPL | ||
| Diagnosis/Medical Criteria | FDA-approved diagnosis | ||
| US Residency Required? | Must live in US, DC or Puerto Rico | ||
Application |
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| Obtaining | Call, download or apply online | ||
| Receiving | Complete online, download from website or faxed. | ||
| Returning | Fax or mail | ||
| Doctor's Action | Complete section, sign, attach required documents | ||
| Applicant's Action | Complete section, sign, attach required documents | ||
| Decision Communicated | Patient and Doctor are notified | ||
| Decision Timeframe | Varies | ||
Medication |
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| Amount/Supply | As prescribed by Doctor | ||
| Sent To | Patient's home | ||
| Delivery Time | Varies | ||
| Refill Process | Patient requests refills via a toll-free number | ||
| Limit | Varies | ||
| Re-application | New application yearly | ||
Additional Information |
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| Co-payment assistance, and patient assistance programs are available for eligible patients. |
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| Updated June 26, 2023 | |||
