Copay support
Helps eligible commercially insured patients with out-of-pocket REMICADE medicine costs, subject to current program limits.
What it does
Supports eligible REMICADE medication costs associated with infusion claims. Enrollment and an EOB or claim record may be required for reimbursement or provider payment.
Open official program pageAvailable to eligible patients with commercial or private insurance and an on-label REMICADE prescription, subject to current savings terms.
Government program exclusions: Medicare, Medicaid, TRICARE, VA, DoD, Other federal or state healthcare programs
Submit through the authorized infusion provider.
Enroll through J&J withMe and provide medical-benefit information.
Submit the EOB or other requested claim records through the program workflow.
Enroll through J&J withMe or the gastroenterology enrollment form. Coordinate with the infusion provider to submit the EOB or claim information required for savings processing.
Best for: Patients or caregivers who can complete the official web form
Enter the requested patient, prescription, contact, and insurance information; select the services requested.
Owner: Patient or caregiver
Patient, REMICADE WithMe, Infusion Provider
REMICADE withMe
Savings, benefits, access, infusion-site, Case Manager, and patient-assistance support.
Monday-Friday, 8 AM-8 PM ET
Official patient-facing cost-support page.
Official patient-support landing page.
Have ready: REMICADE prescription, Contact information, Commercial insurance, Consent
Review the authorization and program terms, provide consent, and submit the form.
Owner: Patient or caregiver
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: Completed patient authorization, Insurance cards, Prescription and prescriber signature
Submit the completed form by fax to 1-855-224-5072.
Owner: Clinic staff
After enrollment: The patient and infusion provider use the assigned savings workflow and retain EOBs for any required submission.
If there is a problem: Call REMICADE withMe about claim rejection, EOB status, or a payment-method problem.
Combined official gastroenterology enrollment form for patient and clinic submission.
