Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis. | |||||||
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Mavyret Patient Support |
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Provided by: AbbVie |
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AbbVie Customer Service, Department TEL: 877-628-9738ALT PHONE: 855-687-7503 FAX: 866-938-6696 |
Languages Spoken:
English, Spanish |
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Patient Assistance Applications |
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Mavyret Patient Support Enrollment Form |
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Brand Name Medications Covered |
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Generic Name Medications Covered |
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Eligibility Requirements |
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Insurance Status | Contact program for details. | ||||||
Those with Part D Eligible? | Contact program for details. | ||||||
Income | Not disclosed | ||||||
Diagnosis/Medical Criteria | FDA-approved diagnosis | ||||||
US Residency Required? | Must be a US resident and treated by a US licensed healthcare provider | ||||||
Application |
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Obtaining | Call or download | ||||||
Receiving | Downloaded from website | ||||||
Returning | Varies | ||||||
Doctor's Action | Complete section, sign, attach required documents | ||||||
Applicant's Action | Complete section, sign, attach required documents | ||||||
Decision Communicated | Patient notified | ||||||
Decision Timeframe | Varies | ||||||
Medication |
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Amount/Supply | Varies | ||||||
Sent To | Varies | ||||||
Delivery Time | Not specified | ||||||
Refill Process | Patient must contact company | ||||||
Limit | Varies | ||||||
Re-application | Not specified | ||||||
Additional Information |
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This program also provides copay assistance. |
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Updated January 16, 2019 |