BAVENCIO

Indicated For

Merkel Cell Carcinoma, Urothelial Carcinoma

About This Medication

# CoverOne Patient Assistance Program Patient Guide: How to Get BAVENCIO (avelumab) at Low or No Cost BAVENCIO (avelumab) is an immunotherapy medication used to treat certain advanced cancers, such as Merkel cell carcinoma (MCC) and urothelial carcinoma (UC), by helping your immune system fight cancer cells. The **CoverOne Patient Assistance Program**, offered by **EMD Serono, Inc.**, provides BAVENCIO at **no cost** to eligible uninsured patients facing financial hardship who meet specific income and insurance criteria. ## About BAVENCIO (avelumab) BAVENCIO is a prescription immunotherapy drug given as an intravenous (IV) infusion, typically every 2 weeks. It's approved for adults with metastatic MCC, certain types of bladder cancer (urothelial carcinoma) that has progressed after platinum chemotherapy, and other cancers when used with other treatments. Your doctor will determine if it's right for you based on your diagnosis, like providing ICD-10 codes and prior treatment history on the enrollment form. Common side effects include fatigue, muscle pain, nausea, rash, and infusion reactions—discuss these with your healthcare provider.[1][2][4] This guide explains how to access free BAVENCIO through CoverOne if you qualify. It's designed for patients, caregivers, and providers to navigate the process easily. ## Who Qualifies for the Program? The program is for **uninsured or underinsured patients** without coverage for BAVENCIO who meet income eligibility based on household size and income. You must be a U.S. resident. Key requirements: - **No federal or state healthcare programs**: Patients on **Medicare, Medicaid**, or similar government programs are **not eligible**. If you gain Medicare coverage, eligibility expires December 31 of that year, and you'll need to reapply.[2][5] - **Income-based**: Certain income thresholds apply (exact Federal Poverty Level percentage not specified; program reviews household income including wages, Social Security, and other sources). Provide proof like tax returns or stubs.[1][2] - **Physician involvement**: Your doctor must confirm BAVENCIO is medically necessary and complete parts of the enrollment form.[2] **Eligibility is not guaranteed** and depends on review. The program reserves the right to request more documents for financial hardship cases.[2] ## Income Eligibility Breakdown Income eligibility is determined by your **total household income** (before taxes) and **household size**. Include all sources: wages, Social Security, unemployment, etc. Specific Federal Poverty Level (FPL) percentages or exact dollar thresholds are not publicly detailed and are evaluated case-by-case. Here's what to expect: | Household Size | Estimated Income Threshold | Required Proof | |---------------|----------------------------|---------------| | 1 (Individual) | Certain level (TBD by program) | Tax return, W2, etc. | | 2 (Couple) | Certain level (TBD by program) | Tax return, W2, etc. | | 3 | Certain level (TBD by program) | Tax return, W2, etc. | | 4+ | Certain level (TBD by program) | Tax return, W2, etc. | **Notes**: Yearly or monthly income accepted. If no tax return/W2, submit 2 months' paycheck stubs, bank statements (showing deposits), Social Security/unemployment statements.[1][2] Always report changes in income or household. ## Insurance Requirements - **Uninsured for BAVENCIO**: No private or public coverage for the drug.[1][2] - **No government programs**: Medicare, Medicaid, VA, etc., disqualify you. Medicare Part D patients should contact the program, but generally ineligible.[5][9] - **Underinsured**: May qualify if no coverage specifically for BAVENCIO.[2] - **Change in status**: Notify CoverOne immediately if you gain insurance—you can't seek reimbursement for free drug from any payer.[2] If commercially insured, explore CoverOne's separate Co-Pay Assistance instead.[6] ## Step-by-Step Application Process 1. **Talk to your doctor**: Discuss BAVENCIO and ask them to complete the CoverOne Enrollment Form (includes patient medical info like ICD-10 codes, prior therapies, planned treatment dates, insurance details).[2] 2. **Gather documents**: - Most recent **Federal/State Tax Return** (e.g., IRS Form 1040) or **W2**. - Alternatives: **2 months Paycheck Stubs**, **2 months Bank Statements**, **Social Security Statements**, **Unemployment Check/Statement**.[1][2] - Patient info: Name, address, DOB, phone, household size/income, consent signature.[2] 3. **Complete the form**: Provider and patient sections. Mark "Patient Assistance Program".[2] 4. **Submit**: Fax to **1-800-214-7295** or use the CoverOne Enrollment Portal (providers start here).[1][2] Phone support: **1-844-8COVER1 (1-844-826-8371)**.[2] 5. **Sign consents**: Authorize sharing medical/financial info for eligibility verification. Agree not to seek reimbursement.[2] **Tip**: Incomplete forms delay processing—double-check everything.[2] ## Timeline and Delivery - **Processing**: Not specified; submit prior to treatment to avoid delays. A CoverOne representative contacts you post-submission.[3] - **Approval**: Case-by-case; expect review of docs. - **Delivery**: If approved, BAVENCIO is **shipped directly to you** (or your provider's office for administration). Free of charge.[1][program details] - **Ongoing**: Notify changes; Medicare enrollment ends eligibility end-of-year.[2] ## Alternatives if Denied or Ineligible - **Co-Pay Program**: For commercially insured—may reduce out-of-pocket to $0 (terms apply; not for government insurance).[5][6] - **Other nonprofits**: Independent organizations (not endorsed by EMD Serono) may help; check Bavencio.com resources.[4] - **AmeriPharma Specialty**: Free service for copay/financial aid, accepts Medicare/Medicaid—contact for BAVENCIO support.[7] - **RxAssist**: Search for similar programs.[9] - **Doctor/hospital aid**: Ask about samples, payment plans, or 340B programs. - **Reapply**: Fix issues (e.g., more docs) and resubmit.[2] No biosimilars available currently.[program details] ## Important Disclaimer This guide is for informational purposes based on available program details as of latest info. **Eligibility, terms, and availability can change**—visit CoverOne.com or call **1-844-826-8371** for updates. EMD Serono/CoverOne not responsible for third-party sites. Participation voluntary; not tied to buying BAVENCIO. Consult your doctor for medical advice. Free drug can't be resold or reimbursed. Program may request more docs. Word count: ~950.

Program information last verified: March 25, 2026