Download the AccessSIVEXTRO™ Enrollment Form
For some, understanding insurance details and navigating coverage for medications can be a challenge. The AccessSIVEXTRO™ program is designed to help you facilitate patient access to SIVEXTRO tablets.
You and your patients can learn more about the program by calling 844-282-4782 to speak to a live representative.
AccessSIVEXTRO™ may help provide assistance with:
- Insurance benefits: contact insurers to obtain coverage and benefits information about patient out-of-pocket costs
- Prior authorization: assist with understanding the prior authorization process
- Co-pay assistance: provide information on co-pay assistance options
- Product availability: assist patients with identifying a local or other pharmacy that stocks SIVEXTRO
- Independent foundations: provide information about independent foundations that may be able to provide financial support to patients. Each independent foundation has its own eligibility criteria and application process
- Referrals to the Merck Patient Assistance Program: for more information on the program's eligibility requirements, please visit Merck Helps™
- Completing the enrollment form
For more information or for answers to specific questions, call AccessSIVEXTRO™ at:
Monday–Friday, 8:00 AM–8:00 PM ET
Saturday, 9:00 AM–1:00 PM ET
If you have trouble connecting to enroll your patient at the numbers above, please use alternate. Phone: 407-888-5304, Fax: 407-888-5305