Copay member information may be provided to you via mail, email address, or mobile phone number for patients who opt-in to text communications, provided during the enrollment/re-enrollment processes.Enrollment information that is modified or does not contain the information required will not be accepted by INSUPPORT for evaluation of Program eligibility.You must request eligibility determination and enrollment for the Copay Assistance Program via the INSUPPORT Patient Enrollment Form or.The INSUPPORT Copay Assistance Program is not insurance.You have been prescribed SUBLOCADE by your treatment provider.Your private insurance has not prohibited coupons/copay assistance for SUBLOCADE.You are a resident of a state where copay assistance is not prohibited.You are a resident of the United States or U.S.The Copay Assistance Program is available to individuals only for "on-label" use.You are at least 18 years of age and less than 65 years of age.Individuals 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.The Copay Assistance Program is not valid for uninsured individuals. You must have private health insurance that provides coverage for some portion of the cost of SUBLOCADE under a medical or pharmacy benefit plan.To receive benefits under the INSUPPORT Copay Assistance Program, you must be determined as eligible and be enrolled in the Copay Assistance Program.
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