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

ARCH Patient Assistance Program for Skyla, Mirena, and Kyleena

Provided by: Bayer HealthCare Pharmaceuticals Inc.


TEL: Closed Program


Languages Spoken:

English, Spanish, Others By Translation Service

 

Patient Assistance Applications

 

Generic Name

 
 

Eligibility Requirements   

Insurance Status Must have no prescription coverage for needed medication
Those with Part D Eligible? Determined case by case
Income Based on FPL
Diagnosis/Medical Criteria Not specified
US Residency Required? Must reside permanently in the US or Puerto Rico
   

Application

Obtaining Call or download
Receiving Faxed, mailed or downloaded from website
Returning Fax or mail
Doctor's Action Complete section and sign
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient and Doctor notified in writing
Decision Timeframe 5-7 business days
   

Medication

Amount/Supply Amount requested is sent
Sent To Doctor's office
Delivery Time Within 2-3 days
Refill Process Not specified
Limit None
Re-application This is a one time program
   

Additional Information

Closed Program: Now known as the Bayer US Patient Assistance Foundation.

Updated October 11, 2018