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SIMPONI ARIA® Website

SimponiAria.com - This website contains additional information about treatment with SIMPONI ARIA®. On this website, you can also get helpful information about your condition.

 

Enrollment

Patient Authorization Form [PDF] - Allows you to authorize the use of your personal information for Janssen CarePath support programs.

Janssen CarePath Savings Program Patient Enrollment Form [PDF] - Allows you to enroll in the Janssen CarePath Savings Program for SIMPONI ARIA®, if eligible. You can also enroll at MyJanssenCarePath.com.

Janssen CarePath Treatment Administration Rebate Program Patient Enrollment Form [PDF] - Allows you to enroll in the Janssen CarePath Treatment Administration Rebate Program for SIMPONI ARIA®, if eligible. You can also enroll online at MyJanssenCarePath.com.

 

Cost Support

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

Janssen CarePath Savings Program Patient Assignment of Benefits Form [PDF] - Allows you to authorize your provider to receive your Janssen CarePath Savings Program rebate on your medication on your behalf.

Janssen CarePath Savings Program Rebate Form [PDF] - Allows you to request a rebate for your medication cost. Rebate requests can also be submitted in your online account at MyJanssenCarePath.com.

Janssen CarePath Treatment Administration Rebate Program Overview [PDF] - Provides information on the Janssen CarePath Treatment Administration Rebate Program for SIMPONI ARIA® and eligibility requirements for enrolling in the program.

Janssen CarePath Treatment Administration Rebate Program Rebate Form [PDF] - Allows you to request a rebate for your medication cost. Rebate requests can also be submitted via your online account at MyJanssenCarePath.com.

Patient Affordability Options for SIMPONI ARIA® [PDF] - Gives information on options that can make your treatment more affordable.

 

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.