Savings and Support

CINQAIR Cost Support Program

If you have commercial health insurance coverage for CINQAIR, you may pay as little as $0 out-of-pocket for the cost of CINQAIR and its administration.

To learn more call CINQAIR Cost Support Program at
1-844-838-2211, Monday through Friday, from 8am
to 8pm ET.  You may also visit
CINQAIRcopay.com to enroll into the Cost Support Program.

$
You may pay as little as

0

per month*

Medication costs
per dose

Administration costs
per treatment

How to use the Cost Support Program Copay Card

If eligible for the CINQAIR® Cost Support Program, you can use your Program Card with your treatment provider to help pay your out-of-pocket costs for treatment with CINQAIR® (reslizumab) Injection.

To the Pharmacist:

By redeeming this Copay Card, you are certifying that you understand and agree to comply with the Terms and Conditions listed herein. When you apply this offer, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription. Submit claim to [PDMI]. If primary coverage exists, input offer information as secondary coverage and transmit using the COB segment of the NCPDP transaction. For questions, please call the Paysign Help Desk at 1-844-838-2211

To the Prescriber:

By redeeming this Copay Card, you are certifying that you understand and agree to comply with the Terms and Conditions listed herein. When you apply this offer, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription. All claim submissions must include a copy of the Explanation of Benefits and a copy of the claim form (CMS-1500, UB04, or electronic equivalent). Claims may be submitted by one of the below methods:

Electronic submission to PAYOR ID PSN22


Fax:

1-844-838-2213


Mail to:

CINQAIR Cost Support Program

PO Box 530492

Henderson, NV 89053


The CINQAIR® Cost Support Program is available to eligible patients who have been prescribed CINQAIR and have commercial prescription insurance. This program is intended for the benefit of patients, not their insurance plans or other third parties. Maximum program assistance per prescription and annual benefit limits per individual apply and out-of-pocket expenses may vary. Patient is responsible for costs above maximum benefit amounts. This program is restricted to residents of the United States and United States territories, subject to applicable law. Uninsured and cash-paying patients are NOT eligible for this program. Patients enrolled in any state or federally funded healthcare program, including but not limited to, Medicare, Medigap, Medicaid, VA, DOD, TRICARE, Puerto Rico Government Health Insurance Plan, Medicare-eligible patients enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees, are NOT eligible for this program. Teva Respiratory, LLC and its affiliates reserve the right to change, rescind, revoke, or discontinue this program at any time without notice. Please see complete Terms and Conditions at CINQAIRTandC.com

Additional resources to help cover the cost of CINQAIR

If you are a Medicare beneficiary in need of co-pay assistance, contact these non-profit organizations for details that may be able to help you with the cost of your medication in the form of a grant.* Please note these organizations are independent of Teva and establish their own eligibility requirements. Teva does not endorse any particular organization, nor make any representation of who may qualify.

Patient Access Network Foundation (PANF)

Healthwell Foundation

Patient Advocate Foundation (PAF)

How the process works:

  1. Contact the 501(c)(3) organization to apply for a grant.
  2. Application requirements vary per 501(c)(3) organization – check with each organization.
  3. When the approval letter is received, provide that information to your Site of Care. Take the approval letter with you to every appointment at your Site of Care.
  4. Note that the billing process between Medicare, the 501(c)(3) organization and your Site of Care can be a lengthy process.
  5. Grants are generally approved by foundations for a period of 12 months
  6. The 501(c)(3) organization that provided your grant generally will reach out to you approximately 2-3 months prior to funds expiring regarding the reapplication process. If you do not hear from the 501(c)(3) organization regarding reapplication, you may reach out to them to inquire.
  7. You must reapply to receive additional funding. Once an approval letter is received, go back to Step 3 and repeat the process.
*Subject to availability of funds and individual program criteria, you may be eligible to apply for these grants.

Teva Cares Foundation

For patients who are uninsured or unable to afford CINQAIR®, the Teva Cares Foundation may be able to help.

Teva Cares is an independent, non-profit program that provides CINQAIR at no cost to eligible patients*. To learn more visit TevaCares.org or call
1-877-237-4881.​

*Patient must reside in the United States, meet insurance and income requirements, and have a valid prescription.