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PONVORY™ Website

PONVORY.com - This website contains information about treatment with PONVORY™. Here, you can also get helpful information about your condition.

 

Enrollment

Janssen Patient Support Program Patient Authorization site - At this link you can electronically sign and submit the Patient Authorization, which allows you to authorize the use of your personal information for Janssen Patient Support Programs including Janssen CarePath.

Janssen Patient Support Patient Authorization Form [PDF] - Or you may download the Patient Authorization Form, print, sign and return to Janssen CarePath to authorize the use of your personal information.

 

Cost Support

Janssen CarePath Savings Program Overview [PDF] - Provides information on the Janssen CarePath Savings Program for PONVORY™ and eligibility requirements for enrolling in the program.

Janssen CarePath Savings Program Rebate Form [PDF] - If for any reason your pharmacy cannot process your card, please submit a Rebate Form to receive a check, when eligible.

Janssen CarePath Pretest Rebate Program Overview [PDF] - Provides information on the Janssen CarePath Pretest Rebate Program for PONVORY™ and eligibility requirements for enrolling in the program.

Janssen CarePath Pretest Rebate Program Rebate Form [PDF] - Allows you to request a rebate for pretests and first dose monitoring as requested by your healthcare provider. You will receive a check for each pretest, if eligible.

Patient Affordability Options for PONVORY™ [PDF] - Information on options that may make your treatment more affordable.

 

Pretest Support

In-Home Pretest Program Overview [PDF] - The In-Home Pretest Program, for eligible commercially insured patients, provides in-home pretest support at no cost for pretests that may be required when starting treatment with PONVORY™.

 

Coverage

Health Insurance Open Enrollment Guide [PDF] - Even if you keep the same health plan, your benefits can change. This guide can help you review your coverage and make changes if needed during the open enrollment period so you can stay on treatment in the new benefit period.

Medicare Resource Guide [PDF] - Provides information on sources for cost support that may be available to patients enrolled in Medicare.

Medicare Part D and Coverage Gap Guide [PDF] - Helps you understand the 4 phases of coverage (Deductible, Initial Coverage, Coverage Gap, and Catastrophic Coverage), and when you will enter the Coverage Gap (formerly known as the Donut Hole).

Medicare Low-Income Subsidy (LIS) Brochure [PDF] - Offers information about extra help with prescription drug costs that is available to low-income residents of the United States enrolled in Medicare Prescription Drug Plans.

 

Other Resources