AMPYRA

Indicated For

Multiple sclerosis, walking improvement

About This Medication

# MyAmpyra Patient Support Program Patient Guide: How to Get AMPYRA (dalfampridine) at Low or No Cost AMPYRA (dalfampridine) is a prescription medication that can help improve walking in adults with multiple sclerosis (MS), and the **MyAmpyra Patient Support Program** from **Merz** offers co-pay assistance to make it more affordable for eligible patients with commercial insurance[1][2][3][5]. This guide explains everything you need to know about qualifying, applying, and getting your medication delivered right to your door. ## About AMPYRA (dalfampridine) **AMPYRA** is an extended-release tablet (10 mg) FDA-approved to help improve walking speed in adults with MS who have walking difficulties. It works by blocking potassium channels to improve nerve signal conduction in the brain and spinal cord, potentially leading to better mobility[1][6]. It's typically taken twice daily, about 12 hours apart, with or without food. Always follow your doctor's instructions, and note that it's not for everyone—discuss side effects like urinary tract infections, dizziness, or seizures with your healthcare provider[6]. MyAmpyra provides more than just cost help: it connects you with a **specialty pharmacy for door-to-door delivery**, offers 1-on-1 support, insurance verification, and refill reminders[2][5]. ## Who Qualifies for MyAmpyra? To join, you must meet these key criteria[1][3][5]: - Be **18 years or older**. - Have a prescription for **AMPYRA for an FDA-approved use** (walking improvement in MS). - Possess **commercial health insurance** (like employer plans or marketplace coverage). - **Not be enrolled in Medicaid, Medicare, or any federal/state/government-funded healthcare program**—if you switch to one, you must exit the program immediately by calling 1-855-866-9255[1][2][3][5]. **No income thresholds** are specified, making it accessible based primarily on insurance type rather than household income[program details]. ## Income Eligibility Breakdown Unlike some programs, MyAmpyra does **not** use strict income limits (null in program details). Eligibility hinges on insurance status. Here's a simple table: | Eligibility Factor | Details | Eligible? | |--------------------|---------|-----------| | **Age** | 18+ years | **Yes** [1][3] | | **Prescription** | AMPYRA for FDA-approved MS walking aid | **Yes** [1][3] | | **Insurance** | Commercial only (no Medicare/Medicaid/federal) | **Yes** [1][2][3][5] | | **Income** | No specific limits | **N/A** | | **Residency** | U.S. residents (implied) | **Yes** | This co-pay program can reduce costs to **as low as $0** for eligible patients, depending on your insurance benefits[9]. ## Insurance Requirements **Commercial insurance is required**—government programs disqualify you[1][2][3][5]. The program verifies your coverage through **benefit investigation** and links you to a specialty pharmacy[2]. You agree not to seek reimbursement from third parties like FSAs/HSAs for program benefits[1][2]. If your coverage changes, notify within **30 days** or call to update/stop participation[1][3]. ## Step-by-Step Application Process Applying is straightforward with **multiple methods**[program details]. Here's how: 1. **Get Prescribed**: Talk to your doctor about AMPYRA. They can complete the **Ampyra Patient Enrollment Form (aPEF)** (downloadable or e-prescribe) and fax to 949-264-1199[7]. 2. **Contact MyAmpyra**: Call **1-855-866-9255** (Mon-Fri, 8 AM-8 PM ET) or visit **https://myampyra.com** to start enrollment[1][3][5][program details]. Provide your info for eligibility check. 3. **Submit Documents**: Upload or provide[program details][7]: - **Enrollment form** (signed by you and doctor). - **Proof of commercial insurance** (insurance card). - **Valid EOB or specialty pharmacy invoice** (for co-pay claims). 4. **Approval & Enrollment**: Once approved, you're **auto-re-enrolled annually** if eligible[1][2][3]. 5. **Receive Medication**: Specialty pharmacy ships to your **door**[2][5][program details]. Your dedicated representative guides you every step[2][5]. ## Timeline and Delivery **Processing time** isn't specified, but expect prompt handling—call for status updates[1]. Medication arrives via **specialty pharmacy door delivery** after approval[2][5][program details]. Refills are managed through the pharmacy with program support; **reauthorization is required** annually or as needed[program details][1]. Get **refill reminders** via email after signing up[4]. ## Alternatives if Denied or Ineligible - **Denied?** Appeal with updated documents or doctor letter of medical necessity[7]. Call 1-855-866-9255 for help. - **Medicare/Medicaid?** Explore state programs or generic options (no biosimilars noted)[program details]. - **Uninsured?** Ask about Merz's **Patient Assistance Program** by calling 1-855-866-9255[1][3]. - **Other MS walking aids**: Discuss alternatives like compounded 4-aminopyridine with your doctor, but check interactions[6]. **Note**: This offer can't combine with other discounts and may change[1][2]. ## Important Disclaimer This guide is for informational purposes only and not a substitute for professional medical or financial advice. Eligibility, benefits, and terms can change; Merz reserves the right to modify/terminate the program anytime without notice[1][2][3]. This is **not health insurance**—restrictions apply[1][5]. Consult your doctor, pharmacist, or call MyAmpyra to confirm details. Report changes in insurance/income within 30 days[1]. See full Terms & Conditions at myampyra.com[5]. Patient support doesn't guarantee coverage; actual co-pays vary by insurance[9]. (Word count: 1028)

Program information last verified: March 30, 2026