Patient Co-Pay Program

 

Manufacturer Co-pay assistance programs available through HealthStat Rx

Please note: The information contained on this page is subject to change at any time without prior notice.

HIV Medications

Aptivus

no co-pay assistance program available at this time

Atripla

Private Insurance or Cash

up to $200 per fill on any out of pocket expense

up to 12 months

Combivir

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

 up to 24 months
Complera Private Insurance or Cash

up to $200 per fill on any out of pocket expense

 up to 12 months

Crixivan

no co-pay assistance program available at this time
Edurant     Private Insurance up to $100 per fill on any out of pocket expense or $5 co-pay up to 12 months

Emtriva

Private Insurance or Cash

up to $200 per fill on any out of pocket expense

up to 12 months

Epivir

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

up to 24 months

Epzicom

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

up to 24 months

Fuzeon

no co-pay assistance program available at this time

Intelence

Private Insurance or Cash

up to $100 per fill after patient pays $5

up to 12 months

Invirase

no co-pay assistance program available at this time

Isentress

Private Insurance

up to $400 per fill on any out of pocket expense

expires 9/30/2012

Kaletra

Private Insurance or Cash

up to $50 per fill on any out of pocket expense plus up to $50 per fill on up to 2 other ARV’s filled at the same time, $100 max

up to 12 months

Lexiva

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

 up to 24 months

Norvir

Private Insurance

up to $75 per fill after patient pays $25

expires 12/31/2011

Prezista

Private Insurance or Cash

up to $100 per fill  after patient pays $5

up to 12 months

Rescriptor

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

expires 11/07/2012

Retrovir

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

 up to 24 months

Reyataz

Private Insurance

up to $200 per fill on any out of pocket expense

up to 12 months

Selzentry

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

up to 24 months

Sustiva

Private Insurance

up to $200 per fill on any out of pocket expense

up to 12 months

Trizivir

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

up to 24 months

Truvada

Private Insurance or Cash

up to $200 per fill on any out of pocket expense

up to 12 months

Videx

no co-pay assistance program available at this time

Viracept

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

 up to 24 months

Viramune

Private Insurance

up to $50 per fill on any out of pocket expense

up to 12 months

Viread

Private Insurance or Cash

up to $200 per fill on any out of pocket expense

up to 12 months

Zerit

no co-pay assistance program available at this time

Ziagen

Private Insurance or Cash

up to $100 per fill on any out of pocket expense

 up to 24 months

Hepatitis C
Incivek  Private Insurance  20% off total co-pay amount per fill          up to 3 dispensings

Pegasys

no co-pay assistance program available at this time

PegIntron

no co-pay assistance program available at this time

Ribavirin

no co-pay assistance program available at this time

Ribapak 

Private Insurance or Cash

up to $65 for the each fill after the patient pays $10

up to 18 dispensings

 

 

 

Crohn’s Disease

Humira

Private Insurance or Cash

up to $1,750 on the first fill after pt pays $5
up to $500 per fill on maintenance dose after pt pays $5 

up to 13 dispensings

Remicade

Private Insurance

up to $550 or more per infusion 1-4 after pt pays $50
up to $550 or more per infusion 5-8 after pt pays $150

up to 8 infusions or 1yr. or $4,400 max

Crixivan

no co-pay assistance program available at this time

Rheumatoid Arthritis

Humira

Private Insurance or Cash

up to $1,600 on first fill after pt pays $5 and up to $500 per fill each month after the patient pays first $5

up to 13 dispensings

Remicade

Private Insurance

up to $550 or more per infusion 1-4 after pt pays $50
up to $550 or more per infusion 5-8 after pt pays $150

up to 8 infusions or 1yr. or $4,400 max
Enbrel     

Private Insurance

50% off your out of pocket expenses or
pay no more than $10 per month max $4,000/6 months

 

up to 12 dispensings

Orencia  

Private Insurance

will cover the full co-pay amount for the first 6 months
of treatment or up to 8 infusions
(must be a new patient to Orencia)

up to 12 months
Cimzia    

Private Insurance or Cash

up to $500 per dose on any out of pocket expenses
up to 50% off your out of pocket expenses or

 

up to 14 doses

Psoriasis

Humira

Private Insurance or Cash

up to $1,600 on first fill after pt pays $5 and up to $500 per fill on maintenance doses after patient pays $5

up to 13 dispensings

Enbrel

Private Insurance

up to $4,000 per 6 month period and
up to 50% off your out of pocket expenses or
pay no more than $10 per month thereafter

up to 12 months

Diabetes

Freestyle

Private Insurance
or Cash

up to $50 per month on any out of pocket
expense

up to 12 months

Freestyle

GA Medicaid     

qualify for a FREE meter (Freestyle Lite or Precision Xtra)

                      

effective 10/1/10
 
 

Cholesterol

Crestor

Private Insurance
or Cash

for insured up to $50 per month after pt pays $18
for non-insured up to $50 off on any out of pocket expense

up to 12 months