Aygestin

Indicated For

endometriosis, amenorrhea

About This Medication

# Organon Patient Assistance Program Patient Guide: How to Get Aygestin at Low or No Cost ## About This Program The **Organon Patient Assistance Program** provides **Aygestin (norethindrone acetate)** free of charge to eligible patients who cannot afford their medication. Organon, the manufacturer of Aygestin, created this program to ensure that financial barriers do not prevent patients from accessing their prescribed treatment. ## About Aygestin Aygestin is a prescription medication containing norethindrone acetate, a synthetic progestin used to treat various gynecological conditions, including abnormal uterine bleeding, endometriosis, and other hormone-related disorders. By providing free medication through this assistance program, Organon helps ensure that patients can continue their treatment without interruption due to cost. ## Who Qualifies for This Program? You may be eligible for the Organon Patient Assistance Program if you meet these criteria: - **You do not have health insurance**, OR - **Your insurance does not cover Aygestin**, OR - **You cannot afford Aygestin even with your insurance coverage** The program evaluates eligibility based on your financial situation, medical need, and insurance status. There are no specific published income thresholds; instead, the program reviews each application individually to determine if you qualify. ## Insurance Requirements To qualify for this program, you must either: - Have **no health insurance**, or - Have insurance that **does not cover** your Aygestin prescription If you have insurance that covers Aygestin but you cannot afford your copay or coinsurance, you may also qualify. The program will review your specific situation during the application process. ## How to Apply: Step-by-Step Instructions **Step 1: Work with Your Healthcare Provider** Contact your doctor's office and let them know you need help affording Aygestin. Ask them to help you complete the enrollment form for the Organon Patient Assistance Program. **Step 2: Complete the Enrollment Form** You have two options: - Download and complete the paper enrollment form with your healthcare provider, or - Complete an electronic enrollment form if available through your provider's system The form will ask for: - Your personal and contact information - Your current household income (before taxes) - Number of people in your household - Insurance information (if applicable) - Your prescription details for Aygestin **Step 3: Submit Your Application** Submit your completed form by: - **Faxing** the paper form to **800-376-2580**, or - **Submitting electronically** through your healthcare provider's system if available Make sure both you and your healthcare provider sign the form before submission. **Step 4: Wait for Contact from the Program** A representative from the Organon Patient Assistance Program will contact you and your healthcare provider's office to confirm your information and determine your eligibility. ## What Documentation Do You Need? To apply, you will need: - **Completed and signed enrollment form** (signed by both you and your healthcare provider) - **Proof of income** (such as recent pay stubs, tax returns, or Social Security statements) - **Insurance information** (if you have insurance) - **A valid prescription** for Aygestin from your healthcare provider No additional supporting documentation is required at the time of application, though the program reserves the right to request additional information during periodic audits. ## Timeline and What to Expect **Application Processing:** The program does not publish a specific processing timeline. After you submit your application, a program representative will contact you within a reasonable timeframe. **Approval Notification:** You will receive notification of approval or denial by **letter or text message**. **Enrollment Period:** Once approved, your enrollment covers a **12-month period** from your enrollment date. If you have Medicare or Medicare Part D coverage, your enrollment will end on December 31st of the current calendar year. **Medication Delivery:** The program will provide information about how your medication will be delivered to you. ## Reauthorization and Refills Before your enrollment period ends, the Organon Patient Assistance Program will contact you with information about **re-enrollment**. You will receive this information with your last prescription refill before your enrollment end date. You will need to complete a new application to continue receiving free Aygestin. ## What If Your Application Is Denied? If you are not approved for the program, the program representative will explain the reason. You may be able to: - Reapply if your circumstances change - Ask about other financial assistance options - Contact your healthcare provider to discuss alternative medications or payment plans - Explore other patient assistance programs or community health resources ## Special Considerations for Medicare Patients If you have **Medicare or Medicare Part D coverage**, your enrollment in the Organon Patient Assistance Program will end on **December 31st** of the current calendar year, even if you enrolled earlier in the year. You will need to reapply each year to continue receiving assistance. ## Need Help? If you have questions about the application process or your eligibility, contact the Organon Access Program: - **Phone:** 866-847-3539 - **Hours:** Monday–Friday, 8 AM to 8 PM ET - **Online:** Visit organonhelps.com for more information ## Important Disclaimer This guide provides general information about the Organon Patient Assistance Program for Aygestin. Program eligibility, requirements, and benefits may change. For the most current and complete information, visit organonhelps.com or contact the Organon Access Program directly. This program is intended only for residents of the United States. Always work with your healthcare provider to determine the best treatment plan for your medical needs.

Program information last verified: March 30, 2026