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Patient Assistance Information

1 Program for Helixate FS vial
CSL Behring Care Coordination Center

PO Box 615011020
First Avenue
King of Prussia, PA 19406
Phone : 877-633-9521
Fax: 844-727-2757
> This programs Insurance requirements vary case by case. Medicare Part D patients are not eligible for this program. Income requirements for this program have not been disclosed. Patient must be citizen or legal resident.
Who Can Apply
> Call to receive application which will be faxed or mailed & must be returned via fax. Doctors action will be discussed with patient and Doctor after request is received. Patient must complete section, sign, attach a copy of proof of income. Decision will be made during phone screening process. No online application.
> Medically appropriate condition/diagnosis is required.
> Amount/Supply varies. Refill process is not specified. Refill limit and re-application process varies.
Ship To
> Shipping varies between both Patient & Doctor's office.
> Since drug availability changes based on inventory, call to make sure requested drug is available. This program lists medications that may be covered under a different CSL Behring savings program: Contact Program for more details The Berinert Copay Benefit covers up to $12,000 in eligible out-of-pocket expenses per year. Patient must be diagnosed with HAE (Hereditary Angleodema) Assurance Program: Once enrolled in the Program, Patient will begin earning an Award Certificate for every 3 consecutive months of therapy use. Each Certificate is worth a 1-month supply of therapy (up to the maximum amount redeemable) and can be redeemed in the event of a lapse in insurance.
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.
Helixate FS vial