Copay Assistance Program | Patient Enrollment | INSUPPORT™ for Healthcare Providers

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Copay Assistance
INSUPPORT offers a Copay Assistance Program for eligible* patients

Copay assistance for eligible patients

INSUPPORT™ is dedicated to helping patients access their treatment. Some of your patients may be eligible for savings on PERSERIS™ (risperidone) for extended-release injectable suspension.

Eligible patients may pay as little as $5 per injection of PERSERIS. Restrictions apply.

The INSUPPORT™ Copay Assistance Program is valid ONLY for patients with private insurance who are prescribed PERSERIS for on-label use. Patients with government insurance are not eligible for the Copay Assistance Program, including, but not limited to, Medicare, Medicaid, Medigap, VA, DoD, TRICARE, CHAMPVA, or any other federally or state-funded government-assisted program. Other restrictions apply.

The Program benefit is valid for the out-of-pocket cost for PERSERIS only. It is not valid for any other out-of-pocket costs including costs associated with the administration of PERSERIS (for example, office visit or medication administration charges). For more information, please refer to the Terms and Conditions for the INSUPPORT™ Copay Assistance Program for PERSERIS.

Enrolling patients in the INSUPPORT Copay Assistance Program

If the patient is not yet enrolled in the INSUPPORT™ Copay Assistance Program for PERSERIS, starting the enrollment process is simple. Note that patients participating in Full Hub Services are automatically enrolled for copay assistance, if eligible.

  1. Download the Patient Enrollment Form using the link below.
  2. Select "Copay Assistance Program" and complete the required steps. Please ensure both provider and patient read the Terms and Conditions for the INSUPPORT™ Copay Assistance Program and provide the required signature and date.
  3. Fax the completed form directly to INSUPPORT™ at 1‑833‑404‑4897 or submit the form online on the INSUPPORT™ Provider Portal.
Download Patient Enrollment Form
English form Spanish form

This form is also available electronically on the INSUPPORT™ Provider Portal.

If you require assistance in other languages, then please call INSUPPORT™ at 1‑844‑INSPPRT (1‑844‑467‑7778).

Need help completing the form? See a sample form below.

Sample Form

Once the patient is enrolled in the INSUPPORTTM Copay Assistance Program

INSUPPORT™ will provide the enrolling healthcare provider with the patient's Copay Member ID for submission of copay claims to INSUPPORT™, as well as copay claim submission instructions. A Copay Member ID card will be provided to the patient in his/her welcome letter upon enrollment in the program.

For more information, please refer to the Terms and Conditions for the INSUPPORT™ Copay Assistance Program for PERSERIS.

FAQs
Does a patient have to use the Copay Assistance Program?

No. The patient does not have to use the Copay Assistance Program in order to receive their PERSERIS prescription.

Can I submit copay claims for a patient that was enrolled in the Copay Assistance Program for PERSERIS by another healthcare provider?

If you have previously enrolled any patient in INSUPPORT or you have a Certification Form for the INSUPPORT™ Copay Assistance Program for PERSERIS on file with INSUPPORT™ for any patient, you may submit copay claims for reimbursement to INSUPPORT™.

If you do not have a Certification Form for the Program on file with INSUPPORT™, you may complete this form and fax to INSUPPORT™ at 1‑833‑404‑4897.

INSUPPORT™ cannot provide reimbursement for copay claims unless a Certification Form is on file.

Why can't patients on Medicare, Medicaid, or other government funded health insurance plans receive copay assistance?

The Office of Inspector General for the US Department of Health and Human Services has stated that pharmaceutical manufacturers providing copay assistance to patients receiving government insurance is inconsistent with federal law. Since Medicare and Medicaid are federal programs, Indivior cannot provide copay assistance to those patients. Other resources may be available to assist Medicare and Medicaid patients.