Temporary access
May provide temporary ENTYVIO at no cost to eligible existing patients during a commercial coverage or authorization interruption.
What it does
Helps a current ENTYVIO patient avoid a treatment gap while a temporary coverage problem is addressed. Official materials state support can last up to six months and is not available before the first dose.
Open official program pagePotentially available to commercially insured patients already receiving ENTYVIO who have a temporary coverage or authorization gap.
Government program exclusions: Medicare, Medicaid, TRICARE, VA, DoD, Other federal or state healthcare programs
Document that the patient has already begun ENTYVIO.
Provide plan correspondence or other requested proof of the temporary gap.
Submit current EntyvioConnect information and a valid order as requested.
The clinic contacts EntyvioConnect, documents the current patient's temporary coverage gap, and submits any updated enrollment, prescription, and plan information requested.
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 And Clinic Staff, EntyvioConnect, Patient, Health Plan, Treatment Site Or Pharmacy
EntyvioConnect
Benefits investigation, authorization, savings, temporary access, patient assistance, and nurse support.
Monday-Friday, 8 AM-8 PM ET
Comprehensive official HCP page describing service eligibility, duration, and benefit limits.
Official enrollment form includes patient, provider, insurance, prescription, and service sections.
Prescriber completes the prescription, clinical, insurance, and service-selection sections and attaches supporting records.
Owner: Prescriber or clinic staff
Have ready: Current prescription, Prior treatment confirmation, Insurance cards, Coverage-gap evidence
Submit the completed form by fax to 1-877-488-6814.
Owner: Clinic staff
After enrollment: If approved, EntyvioConnect coordinates temporary product while the clinic and patient restore coverage.
If there is a problem: Call before the next scheduled dose if the plan issue, authorization, or shipment is not resolved.
