Affordability and Access
Copay savings program
Eligible, commercially insured patients with coverage for XHANCE pay as little as $0 using the XHANCE savings card*
NOTICE OF RESTRICTION FOR VERMONT HEALTHCARE PROVIDERS
If you are a healthcare professional licensed in Vermont, or a licensed healthcare professional who regularly practices in Vermont, Optinose corporate policy and the terms of this program prohibit you from downloading, printing, or accepting the savings card.
See terms and conditions.
*These offers are not valid for use by cash-paying patients or patients enrolled in Medicare, Medicaid, and TRICARE or other federal or state programs. Offers are subject to quantity limitations. Maximum benefits per fill apply. Patient cost share may impact benefits and eligibility. Optinose® reserves the right to rescind, revoke, or amend this offer without notice. Click here for additional terms and conditions.
Access to XHANCE
Use the downloadable assets below to learn more, and advocate on behalf of your patients that are seeking access to treatment with XHANCE.
XHANCE Patient Support Program Flashcard
Discover all of the benefits of the XHANCE Patient Support Program at a glance, from step-by-step access to copay assistance to free delivery.
XHANCE Patient Support Program Prescription Form
Fill out the XHANCE Patient Support Program prescription form for your patients seeking additional XHANCE support.
Letter of Appeal Template
Use this Letter of Appeal template on behalf of patients who have been seeking coverage of treatment with XHANCE.
Letter of Medical Necessity Template
Use this Letter of Medical Necessity template to advocate on behalf of patients seeking coverage of treatment with XHANCE.
Explore More
Find additional information for patients and healthcare professionals
See the results of the XHANCE clinical trials