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Keryx Patient Plus Program
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PO Box 877
Somerville, NJ 08876
Phone
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(855)686-8601
Fax:
(866)310-7424
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Eligibility
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The Keryx Patient Plus Program provides brand name medications at no or low cost. Patients must have no insurance or prescription coverage. For patients with Part D coverage, a determination will be made on a case by case basis. Patients must be above 150% and at or below 300% of the Federal Poverty Level. This medication must be determined as medically necessary by a doctor. Patients must be a US citizen or legal resident. |
| Who Can Apply
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Patients or doctors can call or download the application. |
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Required
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Patients and doctors must complete and sign the application and fax, email or mail with required documents. A new application is needed yearly. |
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Supply
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Up to a 1 month supply. |
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Ship To
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Not specified. |
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Note
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This program also provides co-pay and reimbursement assistance. |
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Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
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| Auryxia tablet |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form |
(Requires Acrobat Reader) 
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