Programs to Make Sucraid® Affordable
The financial burden for managing a rare disease can be significant; however, many patients qualify for financial support. The SucraidASSIST™ program can assist in connecting eligible patients to a range of available financial assistance. Contact the specialty pharmacy at 1-800-705-1962 for more information.
In This Section
SucraidASSIST™ Patient Assistance Program
Program qualifications and eligibility requirements include:
- U.S. residency
- Valid prescription for Sucraid®
- Completed Health Insurance Portability and Accountability Act (HIPAA) form
- Enrollment in the SucraidASSIST™ program
- Income eligibility is below 200% of the current Federal Poverty Level, which varies by household income based on household size
Financial assistance program:
- Financial assistance may be available for patients who meet these income and other eligibility requirements
Copay and/or Deductible Savings Program
Sucraid® Savings Program Eligibility Criteria/Terms and Conditions:
By using the Sucraid® Savings Program, you confirm that you understand and agree to the following terms and conditions:
- This offer is valid for commercially-insured patients being treated with Sucraid® for an FDA-approved indication.
- For Sucraid®, patient is responsible for $5 per Sucraid® prescription filled, with a maximum annual benefit of up to $10,000.
- This offer is not valid for any patient that receives (or is eligible to receive) coverage or reimbursement (in full or in part) for medical treatment and/or prescription drugs through any federal, state, or other government health insurance program (including, but not limited to, Medicare, including Medicare Part D plans, Medicaid, Veterans Administration health coverage, TRICARE or other Department of Defense health coverage, or the Puerto Rico Government Health Insurance Plan). Uninsured and cash-pay patients are not eligible to participate in this program. This offer does not constitute insurance coverage.
- This offer is open to patients residing in the United States (including the District of Columbia and Puerto Rico), except where prohibited by law or otherwise restricted.
- Patient must be receiving treatment from a physician in the United States and product must be dispensed at participating eligible pharmacies in the United States, Puerto Rico, or U.S. territories.
- Patient must be at least 18 years of age to redeem this offer (either for yourself or on behalf of a minor).
- Patient agrees to not seek insurance coverage or reimbursement for the prescription filled, or any part of the value received through this offer. Patient is responsible for reporting utilization of the Sucraid® Savings Program as required by any insurer (or other third-party payer) who pays for any part of the prescription filled.
- Patients receiving free Sucraid® are not eligible to participate in this offer. This offer is not valid with other offers for Sucraid® and cannot be combined with other financial assistance programs for Sucraid®.
- This offer is not transferable and may not be combined with any other offer. The selling, purchasing, trading, or counterfeiting of this assistance is prohibited.
- Offer must be presented along with a valid prescription for Sucraid®. No other purchase is necessary to redeem this offer.
- QOL Medical intends for the full value of the program benefits to be exclusively provided to the patient.
- QOL Medical reserves the right to change or discontinue this offer at any time without notice.
- This card is valid for one year from date of enrollment. Offer limited to one card per person.
- For questions about the Sucraid®Savings Program, call 1-855-672-4110 (Monday through Friday, 8 am – 8 pm EST).