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 conditionsSee terms and conditions.

Be sure to download the XHANCE savings card to receive available savings for your patients.
*

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 hereClick here for additional terms and conditions.

ACCESS TO XHANCE

Use the downloadable assets below to learn more about the Patient Support Program, and advocate on behalf of your patients that are seeking access to treatment with XHANCE.
Patient Support Program Flashcard
Access a snapshot of the services provided by the Patient Support Program.
Patient Support Program Prescription Form
Fill out the Patient Support Program Prescription Form for your patients seeking additional XHANCE support.
Letter of Appeal
Appeal on behalf of patients who have been seeking coverage of treatment with XHANCE.
Letter of Medical Necessity
Submit this Letter of Medical Necessity to advocate on behalf of patients seeking coverage of treatment with XHANCE.