Affordability options may be available for LOKELMA
LOKELMA Co-pay Savings Card
The LOKELMA Co-pay Savings Card may help you pay a set amount of out-of-pocket costs.
AZ&Me Prescription Savings Program provides AstraZeneca medicines at no cost if you qualify.
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.
Who is eligible?
- You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions. Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TRICARE, and patients who are Medicare-eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient. This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age.
What to know
What are the specific costs associated with the LOKELMA Co-pay Savings Card?
The patient pays $0 per 30-packet supply, subject to a maximum savings of $350 per 30-packet supply; patient out-of-pocket expenses may vary. If you pay cash for your prescription, AstraZeneca will pay up to the first $250, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply.
What does the LOKELMA Co-pay Savings Card cover?
The LOKELMA Co-pay Savings Card 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.lokelma.com or call an Access 360 representative at 1-866-494-8080.
The patient pays $0 per 30-packet supply, subject to a maximum savings of $350 per 30-packet supply; patient out-of-pocket expenses may vary. If you pay cash for your prescription, AstraZeneca will pay up to the first $250, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply.
The LOKELMA Co-pay Savings Card covers the cost of the drug, but does not cover costs for office visits or any other associated costs.
No. There are no income requirements to participate in the program.
For additional information, please visit www.lokelma.com or call an Access 360 representative at 1-866-494-8080.
