Program Overview
|
Phone: 1-888-327-RSVP (7787)
Monday to Friday
9 am to 8 pm Eastern Time
Fax: 1-888-773-0121
|
Mailing Address:
Pfizer RSVP
PO Box 220574
Charlotte, NC 28222-0574
|
RSVP stands for the Reimbursement Solutions, Verification, and Payment HELPline. This program offers reimbursement support services and patient assistance to help patients gain access to the following Pfizer specialty medicines: - BeneFix® Coagulation Factor IX (Recombinant)
- Elelyso™ (taliglucerase alfa) for injection
- Rapamune® (sirolimus)
- Revatio® (sildenafil)
- Tygacil® (tigecycline IV)
- Vfend® (voriconazole)
- Xyntha® Antihemophilic Factor (Recombinant), Plasma/Albumin-Free
- Zyvox® (linezolid)
Services for the insured*
RSVP can provide the following benefits for patients with prescription coverage:
- Reimbursement support services: An RSVP counselor will research and verify patients’ benefits for the medicine they need, outline coverage options and policies, and explain the prior authorization process
- Alternate funding assistance: RSVP can help patients find alternate sources of funding, if needed. These may include state pharmaceutical assistance programs (SPAPs), Medicaid, Medicare Part D, low-income subsidies, and charitable foundations
- Appeals process information: If a claim is underpaid or denied, RSVP will investigate and explain the appeals process
Services for the underinsured*
RSVP can provide the following services to patients who have prescription coverage but are experiencing financial hardship (eg, cannot afford their coinsurance or have been denied coverage):
- Free medicine† and co-payment assistance‡: Patients with prescription coverage who are having trouble paying for their medicines can apply for assistance through RSVP. If they meet income guidelines, they may be eligible to either receive their Pfizer medicine for free, or in some cases, obtain an RSVP Co-Pay Card‡ that will cover the full cost of their co-pay. Eligibility varies by product and assistance extends through the end of a calendar year
Services for the uninsured*
RSVP may be able to help patients without prescription coverage get their Pfizer medicines for free. To qualify for free medicines, patients must:
- Have no prescription coverage
- Meet specific income guidelines, adjusted for family size
- Live in the United States, the US Virgin Islands, or Puerto Rico
- Be treated by a licensed doctor in the United States or Puerto Rico
Application process
Applying to receive free medicine or co-payment assistance through RSVP is easy. Just follow these 2 steps:
- Download the RSVP application here.
- Patients and their prescribers must fill out and fax or mail the completed application, along with proof of income, to RSVP.
Note: In some urgent cases, patient eligibility can be determined over the phone. RSVP will then send an initial supply of the necessary medicine to the patient’s home or prescriber’s office, depending on the medicine. If Zyvox® (linezolid) is needed, it can be made available immediately through a local pharmacy once eligibility has been confirmed. However, patients must submit a signed and completed application to RSVP within 30 days to continue receiving assistance. Proof of income includes a copy of one of the following documents that shows total gross annual household income: - Previous year’s federal tax return (form 1040 or 1040EZ)
- Current paycheck stub
- Wage and tax statements (W-2 forms)
- Social security, pension, or railroad retirement statements (SSA-1099 or similar)
- Statements of interest, dividends, or other income (1099-INT, 1099, 1099-DIV, or similar forms)
Application approval
Patients who submit an application by fax or mail will be notified of their acceptance within 2 weeks of applying to the program. If accepted, they will receive their first shipment of medicine at that time. Prescribers will then be responsible for placing any necessary reorders during their patients’ enrollment, which can extend for up to one year.
How patients receive their medicines
RSVP will send medicine to a patient’s home or their prescriber’s office, depending on the medicine. If Zyvox® (linezolid) is needed, it can be made available immediately through a local pharmacy once eligibility has been confirmed.
Your total gross annual household income must be at or below 2 times the federal
poverty level (see the chart below).
- Total number of persons in the household includes yourself and each of your dependents
- Total gross income includes incomes from all earners in your household before taxes
and deductions
|
Annual Income |
$22,340 |
$30,260 |
$38,180 |
$46,100 |
$54,020 |
Please visit
www.aspe.hhs.gov/poverty for more information about federal poverty guidelines.
For households of more than 5 people, or if you live in Alaska or Hawaii, call 1-866-706-2400.
|