Terms and Conditions
BIMZELX Navigate Savings
BIMZELX Navigate® Savings (the “Program”) provides BIMZELX® (bimekizumab-bkzx) to eligible patients with commercial insurance coverage for as little as $5 per dose. Eligible patients must be 18 years of age or older with commercial insurance coverage with a valid prescription consistent with FDA-approved product labeling. The Program is not available (1) for prescriptions that are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, or any other federal- or state-funded healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), (2) where a patient’s commercial insurance plan reimburses for the entire cost of the drug, (3) for uninsured or cash-paying patients, or (4) where otherwise prohibited by law. Product shall be dispensed pursuant to Program rules and federal and state laws. The value of the Program is exclusively for the benefit of patients and is intended to be credited in full toward patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, and deductibles. Patient may not seek reimbursement for the value of this Program from other parties, including third-party payers (i.e., any health insurance program or plan, or public payers like Medicare, Medicaid, Medigap, TRICARE, VA, and DoD). Patient is responsible for complying with any applicable limitations and requirements of their health plan related to the use of the Program. This Program cannot be combined with any other savings, free trial, or similar offer for the specified prescription. UCB, Inc. reserves the right to amend or end this Program at any time without notice. Subject to the prior sentence, this Program expires at 11:59 p.m. on December 31. Patients that meet the above requirements may re-enroll in the Program each year.
BIMZELX Navigate Bridge
BIMZELX Navigate® Bridge (the “Program”) provides BIMZELX® (bimekizumab-bkzx) to eligible patients for $15 per dose for up to two (2) years or until the patient’s commercial insurance plan approves coverage for the drug, whichever comes first. Eligible patients must be 18 years of age or older with commercial insurance and a valid prescription consistent with FDA-approved product labeling. For initial enrollment into the Program, the patient must be experiencing a delay in, or have been denied, coverage for BIMZELX by their commercial insurance plan. To maintain eligibility in the Program, the following are required: (1) a prior authorization request has been submitted and/or coverage remains unavailable for the patient; and (2) if the prior authorization is denied by the payer, the prescriber must submit an appeal within the first sixty (60) days of the prior authorization denial and a prior authorization (or documentation as may otherwise be required by the payer) must be submitted every six (6) months thereafter. Program is not available (1) to patients whose prescriptions are reimbursed, in whole or in part, under Medicare (including Medicare Part D), Medicaid, or any other federal- or state-funded healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), (2) where a patient’s insurance covers the drug, (3) to uninsured or cash-paying patients, or (4) where otherwise prohibited by law. Product shall be dispensed pursuant to Program rules and federal and state laws. Patients may be asked to re-verify insurance coverage status during participation in the Program. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Limitations may apply. This Program cannot be combined with any other savings, free trial, or similar offer for the specified prescription. The patient, or healthcare provider on the patient’s behalf, must not submit any claim for reimbursement for product provided under this Program to any third-party payer. UCB, Inc. reserves the right to end or amend this Program without notice.
If you are uninsured, other financial assistance may be available. Call UCBCares® toll free at 1-844-599-CARE (2273) for more information. Some program and eligibility restrictions apply. Please consult your doctor if you have any questions about your condition or treatment. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
UCB, Inc. is not liable for unintended or unauthorized use of the BIMZELX Navigate Savings Card if it is lost or stolen.