Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 1 of 2.
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MyPraluent Support Program

This program provides brand name medications at no or low cost

Provided by: Sanofi and Regeneron Pharmaceuticals, Inc.


TEL: 844-772-5836


ALT PHONE: 844-855-7277
FAX: 844-855-7278
Languages Spoken:

English, Spanish

Program Website

 

Program Applications and Forms

MyPraluent Patient Assistance Program Enrollment Form

 

Medications

  • alirocumab injection; subcutaneous (Praluent) Injection; Subcutaneous
 

Eligibility Requirements   

Insurance Status Must be uninsured or underinsured
Those with Part D Eligible? Determined case by case
Income At or below 500% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must live in US, DC or Puerto Rico
   

Application

Obtaining Call or download
Receiving Faxed to Doctor's office
Returning Fax from Doctor's office
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

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

Insurance benefits, claims assistance and/or other reimbursement help is offered.

This program also provides copay assistance.

Additional resources available, including a puncture-resistant sharps disposal container and a PRALUENT Travel Kit.

Updated August 12, 2020


Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  
Program 2 of 2.
 

HealthWell Foundation Copay Program

This is a copay assistance program

Provided by: HealthWell Foundation

PO Box 489
Buckeystown, MD 21717

TEL: 800-675-8416


FAX: 800-282-7692
Languages Spoken:

English, Others By Translation Service

Program Website

 

Program Applications and Forms

HealthWell Foundation Copay Program Enrollment: Contact program

HealthWell Foundation COVID-19 Ancillary Costs: Contact program

 

Medications

  • alirocumab injection; subcutaneous (Praluent) Injection; Subcutaneous
 

Eligibility Requirements   

Insurance Status May have insurance
Those with Part D Eligible? Yes
Income Varies
Diagnosis/Medical Criteria FDA Approved Diagnosis - See Program Website for Details
US Residency Required? Must reside in the US
   

Application

Obtaining Call or complete online
Receiving Sent out or may be completed online
Returning Mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient notified in writing
Decision Timeframe 3-5 business days
   

Medication

Amount/Supply Not applicable
Sent To Varies
Delivery Time Not specified
Refill Process Good for one year
Limit Not specified
Re-application New application every 12 months
   

Additional Information

This program provides financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments. Also, for those who are eligible for health insurance, but cannot afford the insurance premium, the foundation may be able to help by paying some or all of the medical portion of insurance premiums. The patient is being treated for a specific disease for which funding is available and has insurance that covers the treatment for this disease.

Call for most recent medications as the list is subject to change.
Updated July 20, 2020