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J Code available effective 1/1/2018:
J0565 (Injection, bezlotoxumab, 10 mg)
AINF-1239239-0000 12/17
THE MERCK PATIENT ASSISTANCE PROGRAM
The Merck Patient Assistance Program provides certain Merck medicines free of charge to eligible patients.
The Merck Access Program representatives can refer you to the Merck Patient Assistance Program.
Who is the program for?
If you do not have insurance or your insurance does not cover ZINPLAVA, you may be eligible for free product from the Merck PatientAssistance Program (if you meet certain financial and medical criteria).
For more information on the program’s eligibility requirements, please visit www.merckhelps.com.
Getting started is simple
1. Work with your health care provider to download and complete the enrollment form, OR complete the electronic patient enrollment form.
2. Submit the electronic patient enrollment form online, OR print and fax the completed downloadable form to 800-977-1957.
3. A program representative will contact you and your health care provider's office.
ENROLL NOW
Questions? Contact The Merck Access Program at 877-709-4455 Mon–Fri, 8 AM to 8 PM ET, to speak to a representative.
