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Azurity Solutions

Financial support options for Myhibbin™ (mycophenolate mofetil oral suspension)

Find medication coverage and patient financial assistance

Co-Pay & Financial Assistance for Myhibbin™

Piggybank Get started quickly, with the Myhibbin Free 1-month Supply Voucher

If you have been prescribed Myhibbin (Mycophenolate Mofetil Oral Suspension) you may be eligible to receive a free 1-month supply voucher, which will allow you to start your treatment quickly. See below for Terms and Conditions of this program.

Terms and Conditions:

This free 1-month supply voucher is not health insurance. Void where prohibited by law. No claim for reimbursement for product dispensed pursuant to this voucher may be submitted to any third party payor, whether a commercial, private or a government payor. Not valid if reproduced. Prescriber ID# required on prescription. This free 1-month supply voucher cannot be combined with any other rebate/offer, free trial or similar offer for the specified prescription

Patient Instructions: This free 1-month supply voucher is valid for up to a 30 day free prescription of Myhibbin (Mycophenolate Mofetil Oral Suspension)Voucher must be presented to your pharmacist along with a valid prescription. One offer per patient per lifetime. Consumers with questions, please call 1-877-809-1342

Pharmacist Instructions: The free 1-month supply voucher must accompany a valid prescription. Voucher only applicable for a 30-day free prescription. One offer per patient per lifetime No substitution allowed. Please dispense at no cost to the patient. For reimbursement, please submit this electronically as a primary claim to CHANGE HEALTHCARE. Do not submit to any other payer. The information printed on the card (or reverse side ) should be used when submitting for reimbursement .For questions, please call the pharmacy Help Desk at 1-800-433-4893

Azurity and its service providers reserve the right to rescind, recall, revoke or amend this offer without notice at any time.

For pharmacy processing questions, please call the Help Desk
For patient questions:
Download the Free 1-month supply Voucher

Money Co-Pay Assistance

$0
co-pay
Co-pay available for as little as $0* for eligible commercially insured patients

Your out-of-pocket cost matters to us

 

Available at all participating pharmacies in the United States*

*except where prohibited by law

Eligible patients may pay as little as $0 out of pocket expenses per 30-day supply of Myhibbin (Mycophenolate Mofetil Oral Suspension).  The total patient out-of-pocket cost is dependent on the patient’s health insurance plan. Offer valid for up to 12 uses in current calendar year. A valid Prescriber ID# is required on the prescription.

Patient Instructions:

In order to redeem this offer, you must have a valid prescription for Myhibbin (Mycophenolate Mofetil Oral Suspension). Follow the dosage instructions given by the doctor. This offer may not be redeemed for cash.  By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described below. If you have questions about the  Myhibbin (Mycophenolate Mofetil Oral Suspension) copay program should call 1-877-809-1342.

Pharmacist Instructions:

Submit the claim to the primary Third Party Payer first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code, (e.g. 8). Reimbursement will be received from CHANGE HEALTHCARE. Valid Other Coverage Code required. For any questions regarding Change Healthcare online processing, please call the pharmacy Help Desk at 1-800-433-4893.

Terms and Conditions

  • This offer is valid in the United States. Void where prohibited by law.
  • Offer not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, Tricare or other federal or state health programs (such as medical assistance programs).
  • The patient or their guardian must be 18 years of age or older to receive Program assistance.
  • Cash Discount Cards and other non-insurance plans are not valid as primary under this offer.
  • If the patient is eligible for drug benefits under any such program, the patient cannot use this offer.
  • Program expires end of current calendar year: Eligible patients will be automatically re-enrolled in the Program on an annual basis.
  • This offer is not transferable and is limited to one offer per person.
  • Not valid if reproduced.
  • Azurity and its service providers reserve the right to rescind, revoke or amend this offer without notice at any time.

For pharmacy processing questions,
please call the Help Desk

For patient questions:

Click here to download the copay coupon

Piggybank Get started quickly, with the Myhibbin Free 1-month Supply Voucher

If you have been prescribed Myhibbin (Mycophenolate Mofetil Oral Suspension) you may be eligible to receive a free 1-month supply voucher, which will allow you to start your treatment quickly. See below for Terms and Conditions of this program.

Terms and Conditions:

This free 1-month supply voucher is not health insurance. Void where prohibited by law. No claim for reimbursement for product dispensed pursuant to this voucher may be submitted to any third party payor, whether a commercial, private or a government payor. Not valid if reproduced. Prescriber ID# required on prescription. This free 1-month supply voucher cannot be combined with any other rebate/offer, free trial or similar offer for the specified prescription

Patient Instructions: This free 1-month supply voucher is valid for up to a 30 day free prescription of Myhibbin (Mycophenolate Mofetil Oral Suspension)Voucher must be presented to your pharmacist along with a valid prescription. One offer per patient per lifetime. Consumers with questions, please call 1-877-809-1342

Pharmacist Instructions: The free 1-month supply voucher must accompany a valid prescription. Voucher only applicable for a 30-day free prescription. One offer per patient per lifetime No substitution allowed. Please dispense at no cost to the patient. For reimbursement, please submit this electronically as a primary claim to CHANGE HEALTHCARE. Do not submit to any other payer. The information printed on the card (or reverse side ) should be used when submitting for reimbursement .For questions, please call the pharmacy Help Desk at 1-800-433-4893.

Azurity and its service providers reserve the right to rescind, recall, revoke or amend this offer without notice at any time.

For pharmacy processing questions, please call the Help Desk
For patient questions:
Download the Free 1-month supply Voucher

Piggybank Patient Assistance Program

For patients without prescription insurance coverage, Myhibbin™ may be covered by Medicaid or Medicare. Patients who need additional financial support may also be eligible for the Patient Assistance Program.

Azurity Solutions offers guidance on medication approval, access, and co-pays to help eligible patients get their Azurity medications.

Learn more about Myhibbin™