This program covers the out-of-pocket drug costs of ORENCIA, not the cost of the infusion or the office visit.
If you qualify, here are some of the benefits you'll discover with the ORENCIA Copay Program for IV Infusion:
- $5 out-of-pocket drug cost per infusion
- no monthly benefit limit
- maximum annual benefit up to $8,000 per 12-month enrollment period
Our IV Infusion Copay Program is open to:
- appropriate patients being treated with ORENCIA for moderate to severe rheumatoid arthritis (RA)
or moderate to severe polyarticular juvenile arthritis (JIA)
- patients who have commercial health insurance that covers the medication costs of ORENCIA
- Note: patients enrolled in Medicare, Medicare Part D, Medicare Advantage, Medicaid, Tricare, Veterans Affairs (VA), Department of Defense (DoD), other state- or federally-funded programs, or where otherwise prohibited by law are not eligible for this program
Participants pay the out-of-pocket drug cost, upfront, for each treatment. Credits will be made to the participants' ORENCIA Copay Program Prepaid MasterCard®, which can be used at their doctor's office toward their next infusion visit.
Terms and Conditions apply. Please see below.
TERMS AND CONDITIONS FOR THE ORENCIA® (abatacept) COPAY PROGRAM FOR IV INFUSION
Eligibility, Terms, and Conditions
- The Copay card is not an insurance card. This program assists patients with their out-of-pocket drug cost of ORENCIA® (abatacept) only, not the cost of the infusion.
- Eligible patients must be appropriate patients for the treatment of moderate to severely active RA or moderate to severely active polyarticular JIA with ORENCIA.
- Eligible patients must have commercial insurance that pays for ORENCIA. Savings are not applicable to out-of-pocket expenses of $5 or less.
- Your acceptance of this offer confirms that this offer is consistent with your insurance and that you will report the value received as may be required by your insurance provider.
- Patients enrolled in Medicare, Medicare Part D, Medicare Advantage, Medicaid, Tricare, Veterans Affairs (VA), Department of Defense (DoD), other state- or federally-funded programs, or where otherwise prohibited by law are not eligible for this program.
- Patients who move from commercial to federally-funded insurance will no longer be eligible for the program.
- Federally-funded commercial insurance plans are NOT eligible.
- All coverage requirements mandated by the insurance company of the eligible patient must be satisfied in order for the program to take effect.
- Proof required for reimbursement must be a valid Explanation of Benefits (EOB) with ORENCIA J Code specific information.
- EOB must be submitted regardless of assigned J Code value.
- EOB must be submitted within 90 days post-infusion to receive benefit.
- First ORENCIA infusion must take place within 60 days of enrollment in the program.
- Enrollment Period is 12 months from date of enrollment.
- Program has a payment cap of $8,000 for the 12-month term of enrollment.
- Benefits may apply to one retroactive infusion that occurred within 45 days prior to the date of enrollment, only for patients who have had their eligibility confirmed by the program.
- Active copay cards are for use at the patient’s participating healthcare provider office where MasterCard® debit cards are accepted.
- Healthcare providers who do not accept electronic transactions will be identified on enrollment form and program benefits will be issued to the participating patient by check.
- When the prescription for ORENCIA is filled directly by a pharmacy, the program card serves as payment mechanism at the pharmacy only.
- For Hospital Outpatient Departments or Alternate Sites of Care, each facility serves as an infusion site-of-care only. Patient is responsible for site of care financial obligation and will receive program benefits by check.
- This offer is valid in the United States, excluding where it is prohibited by law.
- BMS reserves the right to modify or terminate this offer, or the program in its entirety, at any time.
- This is a limited time offer. Other restrictions and exclusions may apply; please refer to THE ORENCIA® (abatacept) COPAY PROGRAM brochure for infusion for more information.