PRALUENT is available at a lower list price, covered by a majority of health plans, and covered by most Medicare Part D insurance plans*
No matter what your insurance coverage is, there may be an option to help you with the cost of PRALUENT. See additional information below to determine what option may be available for you.
Patients with commercial/private insurance (nongovernment-sponsored insurance)
Pay as little as a
$0 copay for PRALUENT†
If eligible, you can use the MyPRALUENT® Copay Card to pay your out-of-pocket costs for your PRALUENT treatment, including deductibles, copays, and coinsurance (up to a maximum assistance of $3,500 each year). Terms and conditions apply.†
Who's eligible for the Copay Card?
- People with commercial or private insurance (not funded through a government healthcare program such as Medicare and similar programs)
- 18 years of age or older
- Have a valid prescription for PRALUENT for an approved indication
- Reside in the 50 United States, the District of Columbia, or Puerto Rico
Please note: There are no income requirements to be eligible for the Copay Card.
* Formulary data are provided by Managed Markets Insights & Technology, LLC (MMIT) and are current as of February 2020. Because formularies do change and many health plans offer more than one formulary, please check directly with the health plan to confirm coverage.
† Eligible patients with commercial insurance not funded through a government healthcare program subject to an annual cap and other program terms and restrictions. This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DOD, TRICARE, or similar federal or state programs.
See if you qualify for the MyPRALUENT® Copay Card. Click here to apply.
Uninsured and Medicare patients
PASS (Patient Assistance Program)
If you do not have health or prescription insurance and meet income restrictions
If you have Medicare Part D insurance that covers PRALUENT and meet income restrictions
You may qualify to receive PRALUENT at no cost through the PASS Program.
Eligible patients can get PRALUENT free of charge for up to 12 months and may submit for renewal.‡ Eligible patients can call 1-844-855-PASS (1-844-855-7277) or work with their healthcare professional to submit an electronic enrollment form.
‡ Eligible patients subject to program restrictions.
Extra Help Program
If you're faced with limited income and resources, there's a US government–funded program that may help you pay some of your Medicare prescription drug costs for all of your prescription medicines. It's called the Extra Help program (also referred to as Low-Income Subsidy) and it offers eligible patients the following:
- Reduced Medicare Part D premiums
- No cost share in the coverage gap or "donut hole"
- Lower drug copays
Filling your prescription
Four tips to help get your prescription filled
After your doctor prescribes PRALUENT, your health plan (insurance) may require your doctor to submit a prior authorization (PA) form. If a PA is required, here are a few tips to guide you throughout the process:
Gather your information
Before you start the process, make sure you know:
- Your health insurance information (insurance plan, member ID, group number)
- Your pharmacy benefit manager (PBM) information (eg, CVS Caremark, Express Scripts, OptumRx)
- Your prescription information
Use this checklist to help you keep track of your current medication, medical history, insurance information, and more. Download now.
Plan with your doctor
When you give your doctor or pharmacy the requested medical information, your doctor will complete and submit a PA form to your health plan for approval. Please note it may take several days for approval and to receive PRALUENT.
If you or your doctor receives a denial from your insurance company, you can:
- Discuss with your doctor why the request was denied and ask if you have the ability to appeal the decision. Your doctor can submit a letter of appeal to your health plan to seek approval
- Call your health plan directly and discuss your situation
Know your rights
Some states have laws called “step therapy override legislation” that may help certain people get access to specialty medications like PRALUENT. Not sure about the drug coverage in your state? You can find your state’s National Association of Insurance Commissioners contact information here
Get your medication
If your PRALUENT prescription has been approved, it will either be delivered to your home or sent to your local pharmacy.
- Depending on your prescription coverage, you and your doctor may have to repeat the steps above once a year to make sure that your insurance continues to cover your prescription
- If you change your health insurance plan, please let your doctor know. You will have to complete the steps above again to make sure that your new insurance covers PRALUENT
Find out if you’re eligible to pay as little as a $0 copay.§
§ Eligible patients with commercial insurance not funded through a government healthcare program such as Medicare, Medicaid, or TRICARE subject to program terms and restrictions.