IncyteCARES for OPZELURA Patient Assistance Program
The IncyteCARES for OPZELURA Patient Assistance Program provides OPZELURA at no cost to eligible patients in need.* You may be eligible if you are uninsured or have Medicare Part D coverage.
You are considered uninsured if you have no prescription insurance. If you have medical insurance, it may not cover OPZELURA. If you are unsure about your coverage, contact your doctor or health plan.
*Terms and Conditions apply. Terms of this Program may change at any time.
The IncyteCARES for OPZELURA Patient Assistance Program provides OPZELURA at no cost to eligible patients in need.* You may be eligible if you are uninsured or have Medicare Part D coverage.
You are considered uninsured if you have no prescription insurance. If you have medical insurance, it may not cover OPZELURA. If you are unsure about your coverage, contact your doctor or health plan.
*Terms and Conditions apply. Terms of this Program may change at any time.
To be eligible for the Patient Assistance Program, you must:
- Be uninsured or have Medicare Part D coverage and cannot afford your copay
- Have a valid prescription for OPZELURA for mild to moderate eczema (atopic dermatitis) or nonsegmental vitiligo
- Have an adjusted annual household income that is less than or equal to 400% of the Federal Poverty Level
Additional eligibility criteria if you have Medicare Part D coverage:
- Have a prior authorization (PA) submitted to your insurance plan by your doctor. If the PA is denied, an appeal must be submitted
- You must be enrolled in a Medicare Part D prescription insurance plan and have expressed and documented an inability to afford your out-of-pocket cost
- You must not be a beneficiary of any of these government insurance or healthcare programs, including, but not limited to:
- Medicaid
- Medicare Part D Low-Income Subsidy (LIS) program†
- Veterans Affairs (VA)
- Department of Defense (DoD)
- TRICARE
- Any State Pharmaceutical Assistance Program (SPAP)
†If you have LIS and your Medicare Part D plan denies coverage for OPZELURA through a PA and appeal, you may be eligible for the Patient Assistance Program.
The table below shows who might qualify for the Patient Assistance Program
If this many people live | You may qualify if your full-year income |
|---|---|
1 person | $63,840 |
2 people | $86,560 |
3 people | $109,280 |
4 people | $132,000 |
5 people | $154,720 |
If you live in Alaska or Hawaii or have a household with more than 5 members, please call IncyteCARES for OPZELURA at 1-800-583-6964 to see if you may qualify.
Income levels are subject to change on an annual basis; the numbers in this table are based on the 2026 Federal Poverty Level Guidelines.
How it works
GETTING
STARTED
Your doctor will need to complete and submit the Patient Assistance Program Enrollment Form for OPZELURA. You will need to sign the form and provide proof of your household income.
Your doctor will need to complete and submit the Patient Assistance Program Enrollment Form for OPZELURA. You will need to sign the form and provide proof of your household income.
PROVIDING PROOF
OF INCOME
To qualify for the Program, IncyteCARES will need to verify your household income. You can either:
Have IncyteCARES verify your income electronically by signing the Electronic Income Verification section on the enrollment form
OR
Submit one of the following, your most recent:
- Federal income tax return (Form 1040)
- W-2 earnings statement from your employer
- Social Security Benefit Verification Letter
Submit the required documentation to your doctor to fax with your Program application or mail it separately to IncyteCARES for OPZELURA PAP, 6000 Park Lane, Pittsburgh, PA 15275.
To qualify for the Program, IncyteCARES will need to verify your household income. You can either:
Have IncyteCARES verify your income electronically by signing the Electronic Income Verification section on the enrollment form
OR
Submit one of the following, your most recent:
- Federal income tax return (Form 1040)
- W-2 earnings statement from your employer
- Social Security Benefit Verification Letter
Submit the required documentation to your doctor to fax with your Program application or mail it separately to IncyteCARES for OPZELURA PAP, 6000 Park Lane, Pittsburgh, PA 15275.
GETTING YOUR
MEDICATION
If you are approved for the Patient Assistance Program, OPZELURA will be shipped to you from the designated Program pharmacy.
- Uninsured: You are enrolled up to 12 months, and after that, you must apply to be re-enrolled
- Medicare Part D coverage: You are enrolled for the calendar year and must re-enroll each year
If you are approved for the Patient Assistance Program, OPZELURA will be shipped to you from the designated Program pharmacy.
- Uninsured: You are enrolled up to 12 months, and after that, you must apply to be re-enrolled
- Medicare Part D coverage: You are enrolled for the calendar year and must re-enroll each year
PRESCRIPTION
REFILLS
You must call IncyteCARES for OPZELURA at 1-800-583-6964 to refill your prescription
You must call IncyteCARES for OPZELURA at 1-800-583-6964 to refill your prescription
Questions?
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