Aptiom

Indicated For

partial-onset seizures

About This Medication

# Sunovion Support Prescription Assistance Program Patient Guide: How to Get Aptiom at Low or No Cost Aptiom (eslicarbazepine acetate) is an anticonvulsant medication used to treat partial-onset seizures in adults and children 4 years and older as an add-on therapy. The **Sunovion Support Prescription Assistance Program** helps eligible **uninsured or underinsured patients** get Aptiom at low or no cost by providing a 30-day supply of medication shipped directly to your home[1][3][9]. ## Who Qualifies for the Program? This program is designed for patients struggling to afford their Aptiom prescription due to financial hardship. **Key eligibility requirements** include: - **Residency**: You must live in the United States, Puerto Rico, or U.S. Virgin Islands[9]. - **Prescription**: A valid prescription for Aptiom from a licensed U.S. healthcare provider, including a diagnosis code[9]. - **Insurance Status**: No prescription coverage for Aptiom (uninsured) or functionally underinsured (limited coverage that doesn't cover the medication)[1][4][9]. - **Income**: Household income at or below program limits, typically aligned with **300% of the Federal Poverty Level (FPL)**, though third-party sources note specific dollar thresholds that vary by family size[9]. - **Treatment**: Must be under the care of a licensed healthcare provider[4]. **Medicare patients** may qualify if they have no coverage for Aptiom or meet underinsured criteria, but government insurance like Medicaid often has separate rules—check with the program[7][9]. ## About Aptiom (Eslicarbazepine Acetate) **Aptiom** is a once-daily oral tablet that helps control **partial-onset seizures** (focal seizures) in people with epilepsy. It works by stabilizing electrical activity in the brain to reduce seizure frequency. Available strengths include 200mg, 400mg, 600mg, and 800mg tablets. Common side effects may include dizziness, headache, nausea, and fatigue—always follow your doctor's instructions and report issues promptly. This program ensures you can continue treatment without interruption due to cost[1][8]. ## Income Eligibility Breakdown Eligibility is based on **total annual household income** compared to **300% of the Federal Poverty Level (FPL)** or fixed thresholds provided by third-party estimates. Income includes wages, Social Security, pensions, etc. Provide proof like tax returns, pay stubs, or non-filing verification[4][9]. Here's a **sample income table** (2026 estimates; confirm current FPL with program as guidelines change): | Household Size | Max Annual Income (Third-Party Estimate) | Approx. 300% FPL | |----------------|------------------------------------------|-------------------| | 1 (Individual) | $40,000 | $45,000 | | 2 (Couple) | $60,000 | $61,000 | | 3 | $100,000 | $77,000 | | 4 | $100,000 | $92,000 | | 5+ | Varies; contact program | Add ~$15,000/person | *Notes: Thresholds vary by family size and are third-party estimates. Exact limits based on current FPL—call 1-877-850-0819 to verify[3][4][9].* ## Insurance Requirements The program targets **uninsured or underinsured patients** with **no prescription coverage for Aptiom**. Attach copies of insurance cards (front/back) to show status. If you have commercial insurance but high copays/out-of-pocket costs making it unaffordable, you may qualify as underinsured. **Medicare Part D** patients without Aptiom coverage or in the coverage gap may apply, but full Medicaid patients typically do not qualify for free meds from manufacturers[1][4][7][9]. ## Step-by-Step Application Process **Multiple application methods** make it accessible: mail, fax, or download forms[1][3][4]. 1. **Check Eligibility**: Call **1-877-850-0819** (toll-free) or visit the Sunovion Support website to confirm you qualify. Speak to a specialist for questions[4]. 2. **Get the Form**: Download from the website, request by phone, or ask your doctor. Patients and doctors both complete sections[1][3][9]. 3. **Gather Required Documents**: - **Proof of income** (tax return, pay stubs, Social Security statement, or non-filing verification)[4]. - **Proof of residency** (utility bill, lease)[3]. - **Prescription** for Aptiom with diagnosis code[9]. - **Insurance status** (cards front/back; pharmacy statements if applicable)[4][7]. 4. **Complete the Form**: - **Patient section**: Fill personal info (name, address, income, household size), sign HIPAA/income authorizations[2][3]. - **Doctor section**: Your healthcare provider completes their part, signs, and attaches prescription[4][9]. 5. **Submit**: Doctor faxes/mails to Sunovion Support Prescription Assistance Program, PO Box 220285 (address on form). Or use online portal if available[3][4]. **Tip**: Use blue/black ink; review for completeness to avoid delays[6]. ## Timeline and Delivery Processing takes **several business days to 2 weeks**; if info is missing, they'll contact you. Once approved, expect a **30-day supply shipped free to your home** (delivery method: shipped to patient). **Reauthorization is required**—your doctor must resubmit before each refill[1][3][9]. Track status by calling 1-877-850-0819[4]. ## Alternatives if Denied If denied, you'll receive a letter explaining why (e.g., income too high, insurance covers it). Options include: - **Reapply** with updated documents. - **Copay savings cards** via Sunovion Support for commercially insured (different from PAP)[8]. - **Other PAPs**: RxHope, NeedyMeds, or PAN Foundation. - **State programs**, generic alternatives, or doctor samples. - **Appeal**: Contact program for clarification[2][4]. **No biosimilar alternatives** for Aptiom currently[3]. ## Important Disclaimer This guide is for informational purposes based on available program details as of 2026. **Eligibility, income limits, and processes can change**—always verify with Sunovion at 1-877-850-0819 or official sources. Not legal/medical advice. Consult your doctor for treatment options. Program not for patients with government coverage where prohibited. Third-party fees for application help are not program-affiliated[2][4]. (Word count: 1028)

Program information last verified: March 30, 2026