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Copay Assistance

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

INSUPPORT® offers a Copay Assistance Program designed to help eligible patients with the out-of-pocket costs for SUBLOCADE® (buprenorphine extended-release) injection, for subcutaneous use (CIII).

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

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

Enrolling eligible patients in the INSUPPORT® Copay Assistance Program

If the patient is not yet enrolled in the INSUPPORT® Copay Assistance Program for SUBLOCADE, starting the enrollment process is simple.

Note that for patients enrolled in "Benefit Coverage Information", INSUPPORT® will automatically determine eligibility and enroll an eligible patient in the Copay Assistance Program for SUBLOCADE.

There are two ways to enroll a patient in the program:

  1. Online Enrollment

    You may enroll an eligible patient online by going to the INSUPPORT® Copay Assistance Portal located at www.insupportportal.com. If the patient is not in the office at the time of enrollment, you may request patient authorization from the Portal and the patient can complete and submit the form to INSUPPORT® via DocuSign. Once the patient authorization is received, INSUPPORT® can process the request. Please ensure both provider and patient read the Terms and Conditions for the INSUPPORT® Copay Assistance Program and provide the required electronic signature and date.

  2. Patient Enrollment Form

    1. Download the Patient Enrollment Form using the link below.
    2. Select "Copay Assistance Program for SUBLOCADE" and complete the required steps outlined on page 1. Please ensure that the signature and date are provided on both the Provider Attestation and Patient Authorization.
    3. Fax the completed form directly to INSUPPORT® at 1-844-814-0669.

Download Patient Enrollment Form

English form Spanish form

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


Once the patient is enrolled in the INSUPPORT® 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 (this information is provided immediately if using web enrollment). 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 SUBLOCADE.

*Eligibility

The INSUPPORT® Copay Assistance Program is valid ONLY for patients with private insurance who are prescribed SUBLOCADE 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.

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

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 SUBLOCADE prescription.

Can I submit copay claims for the patient if I am not the patient's enrolling healthcare provider?

You will need to work with the patient to update the provider enrollment information in order to receive any copay claim reimbursement for that patient. In addition, an executed Patient Authorization and Provider Attestation are required for claim payment. You may work with the patient to complete enrollment via the INSUPPORT® Patient Enrollment Form or the INSUPPORT® Portal. Once the necessary documentation is received, INSUPPORT® will confirm eligibility and if eligible, provide you with the enrolled patient's Copay Member ID for submission of copay claims to INSUPPORT®, as well as copay claim submission instructions.

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.