Affordability options may be available for CALQUENCE

CALQUENCE Co-pay Savings Program

The CALQUENCE Co-pay Savings Program helps assist eligible, commercially insured patients with out-of-pocket costs.

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AZ&Me Prescription Savings Program provides AstraZeneca medicines at no cost to qualifying patients.

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Independent Patient Assistance Foundations

Assistance may be available through independent foundations such as those listed below. Foundations can provide a variety of assistance types: co-pay, transportation, premium, patient education, etc.

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Who can apply?

  • Patients who are covered by commercial insurance, and their insurance does not cover the full cost of their prescription
  • Residents of the United States or Puerto Rico
  • Patients are ineligible if prescriptions are paid by any state or Federally funded programs, including but not limited to, Medicare Part B, Medicare Part D, Medicaid, Medigap, Veterans Affairs, Department of Defense, or TRICARE
  • Patients with a valid prescription to accompany the CALQUENCE Co-pay Savings Program offer
ENROLL A PATIENT

What to know

How long is this offer valid?

The offer is valid for 120 days from the date of service. Any claims or transactions made after 120 days from the date of service will not be valid.

What happens once an eligible patient is enrolled in the CALQUENCE Co-pay Savings Program?

A Co-pay Savings Program account will be created for the eligible patient. This can be done by the pharmacy or by calling an Access 360 representative. Once enrolled, the patient will continue to pay a set amount of his or her out-of-pocket costs for CALQUENCE. The pharmacy will use the Co-pay Savings Program to cover the balance, up to the program maximum.

What are the specific costs associated with the CALQUENCE Co-pay Savings Program?

The patient pays $0 per 30-day supply, program pays remaining out-of-pocket costs up to a maximum of $26,000 per year.

What does the CALQUENCE Co-pay Savings Program cover?

The CALQUENCE Co-pay Savings Program covers the cost of the drug, but does not cover costs for office visits or any other associated costs.

Are there income requirements to participate in the program?

No. There are no income requirements to participate in the program.

Where can I find additional information?

For additional information, please visit www.astrazenecaspecialtysavings.com or call an Access 360 representative at 1-844-ASK-A360 (1-844-275-2360).

Who can apply?

  • People without health insurance
  • Medicare Part D and/or B recipients
  • Those who have recently experienced a financial crisis
  • Legal residents of the United States or Puerto Rico
ENROLL A PATIENT

What to know

Eligibility rules apply, please call an AZ&Me representative for more information at 1-800-AZandMe (1-800-292-6363).

Who can apply?

These foundations are not associated with AstraZeneca; specific details and eligibility requirements can be found directly at the foundations’ websites.

Find a foundation

Patient Access Network Foundation

www.PANfoundation.org 1-866-316-7263

Good Days Fund

www.mygooddays.org 1-877-968-7233

Patient Advocate Foundation

www.patientadvocate.org 1-800-532-5274

HealthWell Foundation

www.healthwellfoundation.org 1-800-675-8416

CancerCare Co-Payment Assistance Foundation

www.cancercare.org 1-866-552-6729

The Assistance Fund

www.theassistancefund.org 1-855-845-3663

Leukemia & Lymphoma Society

www.lls.org 1-800-955-4572

Patient Services, Inc.

www.patientservicesinc.org 1-800-366-7741

What to know

For more information and additional resources, visit: https://www.astrazeneca-us.com/medicines/Affordability.html or call an Access 360 representative at 1-844-ASK-A360 (1-844-275-2360).

 
If you are enrolled in a state or Federally funded prescription insurance program, you may not use this program even if you elect to be processed as an uninsured (cash paying) patient. Medicare Part B covers medically necessary services and supplies. Also covers drugs prescribed and administered by a healthcare provider If you are still working, retired, or have purchased a private insurance policy and are receiving prescription coverage through an employer, union, or private insurance plan, you are not eligible for AZ&Me. Also, if you are a current or retired Federal employee (non-military), and receive prescription coverage through the Federal Employees Health Benefits Program (FEHB), you are not eligible for AZ&Me. Finally, if you are military (active or non-active duty) and receive prescription coverage through TRICARE or Veterans Affairs (VA), you are not eligible for AZ&Me. For additional information, please call an AZ&Me representative at 1-800-AZandMe (1-800-292-6363). Medicare Part B refers to Medical Insurance. Generally, these are drugs administered by a doctor or in an outpatient setting. Medicare Part D is Prescription Drug Coverage, which are generally self-administered drugs. Check your patient’s insurance plan to accurately determine the type of coverage they receive. Example: Rob’s take-home pre-tax income is $30,000 per year. Rob’s out of pocket expenses on his prescription cholesterol medication is $100 per month, which is 4% of his annual income. Rob would qualify for AZ&Me if all other eligibility requirements are met.