Coverage Information & Co-pay Savings

Benefits Investigation and Filling Your Prescription

Find out your insurance coverage for BENLYSTA

While many insurance companies offer coverage for BENLYSTA, benefit designs can vary. To understand how your insurance covers BENLYSTA, contact your insurance company.

Or, for help from our team at BENLYSTA Gateway, download the BENLYSTA Gateway Services Form. Check the box “Benefits Verification” on the front of the form. Then work with your doctor to fill out the rest, sign it on the back, and fax it to us. After reviewing your information and contacting your payer, BENLYSTA Gateway will contact you with information about your coverage for BENLYSTA.

How your prescription for BENLYSTA is filled

Filling your prescription for BENLYSTA may be a little different from what you are used to. Read below to find out how the process works.

  • Instead of being filled at a local pharmacy, your prescription for BENLYSTA Subcutaneous (SC) Self-Injection may be filled by a specialty pharmacy. Specialty pharmacies are designed to better support patients with certain conditions or medications.
  • For BENLYSTA SC, the specialty pharmacy will need to contact you to coordinate delivery and collect co-pay. Be sure to return any calls from the specialty pharmacy.
  • For the IV Infusion, your doctor will have your prescription sent directly to their office or an office that specializes in administering infusions.
  • For BENLYSTA IV, your doctor will work through the approval process with your insurance company. Coverage for BENLYSTA will likely require your doctor to complete a prior authorization, so your insurance can determine you to be an appropriate patient for BENLYSTA.
  • While this is how the process usually happens, your experience may be a bit different. The actual process, including how long it will take to receive your prescription, varies.

Get started

Work with your doctor to begin the approval process for BENLYSTA. As you work together to complete it, you may have questions.

BENLYSTA Co-pay Program

What it covers?

  • Helps eligible patients with their co-pay
  • Helps with up to a total of $11,000 per year

You may be eligible for the Program if:

  • You have a commercial medical or prescription insurance plan; or you are uninsured
  • You are under the age of 65
  • You are a resident of the US (including the District of Columbia, Puerto Rico and the US Virgin Islands)

You are not eligible for the Program if:

  • You have a state- or federal government-funded medical or prescription insurance plan such as Medicare, Medicaid, VA, or Tricare
  • You are Medicare-eligible (those who are aged 65 or older are deemed Medicare-eligible)
  • You are enrolled in a commercial health plan that does not permit the use of co-pay assistance programs

How to apply?
Complete a BENLYSTA Gateway Service Request Form to receive a determination of eligibility.
Click here for full Program Terms & Conditions.

Call us at 1-877-4-BENLYSTA (1-877-423-6597) or talk to your doctor to get started.

The BENLYSTA Co-pay Program helps eligible approved patients with their out-of-pocket costs for BENLYSTA up to $11,000 for 12 months. Medicare-eligible patients, and patients enrolled in government-funded programs, are not eligible for the BENLYSTA Co-pay Program. Patients must submit a Service Request Form so their eligibility can be determined. Click here for full Program Terms & Conditions.