![]() ![]() (See PROGRAM DETAILS section in the full Terms & Conditions.) Please ask your Amgen SupportPlus Support Representative to help you understand eligibility for the Amgen SupportPlus Co-Pay Card by calling (866) 264-2778. Patients are responsible for all amounts that exceed this limit. $25 out-of-pocket for each dose of Prolia® or EVENITY®Īmgen will pay the remaining eligible out-of-pocket costs on behalf of the patient until the Amgen payments have reached either the Maximum Program Benefit and/or the Patient Total Program Benefit.$0 out-of-pocket for each dose or cycle of the Amgen SupportPlus product (excluding Prolia® and EVENITY®).Amgen SupportPlus patients may pay as little as:.(See PROGRAM BENEFITS section in the full Terms & Conditions.) Please ask your Amgen SupportPlus Support Representative to help you understand eligibility for the Amgen SupportPlus Co-Pay Card, whether your particular insurance coverage is likely to result in your reaching the Maximum Program Benefit or your Patient Total Program Benefit amount by calling (866) 264-2778. Whether you are eligible to receive the Maximum Program Benefit or Patient Total Program Benefit is determined by the type of plan coverage you have. If a patient's commercial insurance plan imposes different or additional requirements on patients who receive Amgen SupportPlus Co-Pay Card benefits, Amgen has the right to modify or eliminate those benefits. The Amgen SupportPlus Co-Pay Card provides support up to the Maximum Program Benefit or Patient Total Program Benefit. The Amgen SupportPlus Co-Pay Card does not cover any other costs related to office visits or administration of the product. Out-of-pocket costs may include co-payment, co-insurance, and deductible out-of-pocket costs. The Amgen SupportPlus Co-Pay Card may help lower your Amgen SupportPlus product out-of-pocket medication costs.(See ELIGIBILITY section in the full Terms & Conditions.) It is not valid for cash paying patients or where prohibited by law. The program is not valid for patients whose prescription for an Amgen SupportPlus product is paid for in whole or in part by Medicare, Medicaid, or any other federal or state healthcare program. The Amgen SupportPlus Co-Pay Card is open to patients with commercial insurance that covers an Amgen SupportPlus product listed above, regardless of financial need.These terms and conditions apply to the following products:īLINCYTO® (blinatumomab), IMLYGIC® (talimogene laherparepvec), KANJINTI® (trastuzumab-anns), KYPROLIS® (carfilzomib), LUMAKRAS® (sotorasib), MVASI® (bevacizumab-awwb), NEULASTA® (pegfilgrastim), NEUPOGEN® (filgrastim), NPLATE® (romiplostim), PROLIA® (denosumab), RIABNI™ (rituximab-arrx), VECTIBIX® (panitumumab), XGEVA® (denosumab), EVENITY® (romosozumab-aqqg), and AVSOLA® (infliximab-axxq) The following summary is not a substitute for reviewing the Terms and Conditions in their entirety. It is important that every patient read and understand the full Amgen SupportPlus Co-Pay Card Terms and Conditions. There are specific rules for filling prescriptions for certain types of drugs.Amgen® SupportPlus Co-Pay Card Terms and Conditions Is prescribed for an amount more than the normal limitĬheck the TRICARE Formulary to see if you need pre-authorization.Is a brand-name prescription drug with a generic substitute.Is specified by the DoD Pharmacy & Therapeutics Committee.Pre-authorization RequirementsĬertain prescriptions require a pre-authorization. You may need pre-authorization for your prescription if it: ![]() ![]() They depend on the medical effectiveness and cost effectiveness of a drug compared to other similar drugs. These categories follow industry standards. Prescription drugs fall into four categories: Your costs will vary depending on your drug category. We review and update the TRICARE Formulary each quarter. After each review, some drugs may move from one category to another. You’ll get a letter from Express Scripts if you have a prescription for a formulary drug that’s changing to a non-formulary drug. Prescription drugs may be covered under the pharmacy benefit or the medical benefit. The TRICARE Formulary is a list of generic and brand-name prescription drugs that we cover. TRICARE covers most prescription drugs approved by the Food and Drug Administration (FDA). If you use the US Family Health Plan, you have a separate pharmacy coverage. TRICARE provides prescription drug coverage with most TRICARE health plans. ![]()
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