VYEPTI Financial Assistance Guide

This category includes insurance plans provided through an employer, purchased with subsidy support from the Affordable Care Act (Obamacare) or purchased privately.

Highlights of VYEPTI Copay Assistance Program

There may be assistance to help you save on the cost of VYEPTI. If you have commercial insurance, you may be eligible to save on the cost of treatment through the VYEPTI CONNECT Copay Assistance Program. You may pay as little as $0 per infusion, every 3 months.* Offer includes up to $200 in administration fees per VYEPTI treatment. SEE FULL DETAILS AT THE VYEPTI SITE.

• VYEPTI CONNECT Copay Assistance Program will determine your eligibility, if you enroll
• When your enrollment is complete and approved, you and your healthcare provider will receive a confirmation letter that contains your copay program information
• You can save on copay if you meet all the VYEPTI CONNECT Copay Assistance Program Terms and Conditions

You could save on your copay if you

• Are 17 years of age or older
• Have commercial insurance that covers VYEPTI
• Have a valid prescription for VYEPTI
• Are not enrolled in any state or federal healthcare programs
• Live in the United States or Puerto Rico
• Meet all other eligibility requirements set forth in the VYEPTI CONNECT Copay Assistance Program Terms and Conditions

You may be eligible for direct reimbursement from the VYEPTI CONNECT Copay Assistance Program if:

• Your clinic or infusion center does not accept payment for medication costs directly from the VYEPTI CONNECT Copay Assistance Program
• You have paid for your VYEPTI medication costs while enrolled in the VYEPTI CONNECT Copay Assistance Program

If eligible for direct reimbursement, please mail or fax your explanation of benefits (EOB) and receipt to the VYEPTI CONNECT Copay Assistance Program at:

MAIL:

VYEPTI CONNECT Copay Assistance Program
2250 Perimeter Park
Suite 300
Morrisville, NC 27560

FAX: 866-218-3479

You may be responsible for a 20% coinsurance for VYEPTI after you fulfill your deductible. If you have a Medicare supplemental insurance plan (also called Medigap), or a Medicare Advantage Plan (Medicare Part C), your out-of-pocket (OOP) costs may be lower. These plans help cover some of your OOP expenses not paid by Medicare.

Call 1-800-MEDICARE (1-800-633-4227) or check with your insurance provider if you have any questions.

You may be able to get VYEPTI at little to no cost. If you are subject to an out-of-pocket (OOP) cost, it may vary based on the state you live in or your household income.

The Lundbeck Migraine Patient Assistance Program may be available to patients who have limited financial resources and who do not have insurance coverage for their medication.

Eligibility requirements can be found here.