Temporary access
May provide up to two months of ZYMFENTRA at no cost after an eligible patient loses commercial coverage because of a job or other qualifying life event.
What it does
Provides short-term product while the patient secures new commercial coverage. This is distinct from START, which addresses an initial coverage delay or denial.
Open official program pagePotentially available to an existing ZYMFENTRA patient who loses commercial insurance because of a qualifying job or life event and is working to obtain new commercial coverage.
Provide termination or qualifying-event documentation requested by the program.
Submit or confirm the current prescription.
Complete any updated consent and contact information.
Call Celltrion CONNECT promptly after the coverage loss. Patient and clinic provide the qualifying-event evidence, updated prescription, authorization, and any requested insurance records.
Best for: Patients who recently lost commercial coverage
Provide the requested prescription, insurance, contact, and consent information.
Owner: Patient or caregiver
Have ready: Prescription details, Insurance card, Prescriber contact information
Patient, Prescriber And Clinic Staff, Celltrion CONNECT, Employer Or Health Plan, Specialty Pharmacy
Celltrion CONNECT
Enrollment, savings, benefits, authorization, temporary access, Nurse Connector, and patient assistance.
Monday-Friday, 8 AM-8 PM ET
Comprehensive official support page with current temporary-access rules.
Official combined enrollment form with three submission paths.
Best for: Services requiring clinical information, a prescription, or prescriber attestation
Patient completes demographics and the authorization/consent section of the official form.
Owner: Patient
Have ready: Contact information, Signature and date
Prescriber completes the prescription, clinical, insurance, and service-selection sections and attaches supporting records.
Owner: Prescriber or clinic staff
Have ready: Coverage termination evidence, Current prescription, Patient authorization, New coverage plan when known
Submit the completed form by fax to 1-833-912-3707.
Owner: Clinic staff
After enrollment: If approved, Celltrion CONNECT coordinates up to two months of product while the patient obtains new commercial coverage.
If there is a problem: Call immediately if a dose is approaching or new coverage begins before the BRIDGE period ends.
