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Commercial prescription drug insurance through an employer-sponsored or private health plan or the Federal Employee Health Benefit Plan.
Prescription insurance coverage through a state or federal healthcare program, including but not limited to Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA) or Department of Defense (DOD) programs.
I am not covered by prescription drug insurance.
TerSera Therapeutics LLC will use the personal information in this form, including contact, prescription, insurance, and medical condition to enroll you in the XERMELO Savings Program and send you related communications. You can terminate your enrollment at any time. For more information, visit https://tersera.com/privacy-policy.
Based on the information provided, this patient is not eligible for the program. The XERMELO Co-pay Program is only available to commercially insured patients who reside in the United States and US territories. If you have questions or need further assistance, please call the support team at 1-844-539-7427.