PERSERIS

INSUPPORT Copay Assistance Program Patient Guide: How to Get PERSERIS at Low or No Cost

About PERSERIS

PERSERIS (risperidone) is an extended-release injectable medication used to treat schizophrenia in adults. As an injectable treatment, PERSERIS offers a different delivery method compared to daily oral medications, which some patients find helpful for managing their condition consistently.

Who Qualifies for INSUPPORT Copay Assistance

To be eligible for the INSUPPORT Copay Assistance Program, you must meet all of the following requirements:

• Be at least 18 years old
• Be a resident of the United States or U.S. territories
• Live in a state where copay assistance is permitted
• Have private health insurance that covers at least some portion of PERSERIS costs
• Have private insurance that allows copay assistance programs
• Be prescribed PERSERIS by your healthcare provider for its approved use (schizophrenia)
• Not be enrolled in government-funded insurance programs

Insurance Requirements

Private Insurance Only: The INSUPPORT program is exclusively available to patients with private health insurance. If you have any of the following types of insurance, you are not eligible for this copay assistance program:

• Medicare
• Medicaid
• Medigap
• Veterans Affairs (VA)
• Department of Defense (DoD)
• TRICARE
• CHAMPVA
• Any other federally or state-funded government assistance program

If you have government insurance, INSUPPORT may be able to help you find other resources or assistance options. Contact them at 1-844-467-7778 to learn about alternatives.

Income Eligibility

The INSUPPORT Copay Assistance Program does not have specific income thresholds or limits. Eligibility is based on having private insurance coverage and meeting the other requirements listed above, regardless of your household income.

How to Apply for INSUPPORT Copay Assistance

Step 1: Gather Required Documents

Before starting your application, have the following items ready:

• A valid prescription for PERSERIS from your healthcare provider
• Your private health insurance card
• Your Social Security number or tax ID
• Proof of residency (if requested)

Step 2: Complete the Patient Enrollment Form

You can obtain the INSUPPORT Patient Enrollment Form through:

• Your healthcare provider's office
• The INSUPPORT website at www.INSUPPORT.com
• By calling INSUPPORT at 1-844-467-7778 (interpreters available for other languages)

Complete all sections of the form carefully, ensuring all information is accurate.

Step 3: Submit Your Application

You have multiple options for submitting your completed enrollment form:

• Online: Visit www.INSUPPORT.com/savings to submit electronically
• By Mail or Fax: Fax all pages to 844-814-0669 or mail to the address provided on the form
• By Email: Send all pages to enroll@insupport.com
• Through Your Provider: Your healthcare provider can submit the form on your behalf

Step 4: Provide Patient Authorization

You must provide written authorization for INSUPPORT to enroll you in the program. This authorization:

• Is valid for five years from the date you sign it
• Must be renewed each calendar year to continue receiving benefits
• Can be provided with your enrollment form or submitted separately

Step 5: Receive Your Copay Member ID

Once approved, you will receive:

• A welcome letter confirming your enrollment
• A Copay Member ID card
• Instructions for using your benefits

Program Benefits and Coverage

The INSUPPORT Copay Assistance Program helps reduce your out-of-pocket costs for PERSERIS injections. The specific copay assistance available depends on your individual insurance plan and circumstances.

Important: This program covers copay assistance for PERSERIS only. It does not cover:

• Office visit charges
• Medication administration fees
• Other healthcare costs

Timeline and Delivery

Processing Time: The search results do not specify an exact processing timeline. Contact INSUPPORT at 1-844-467-7778 to ask about expected approval timeframes for your specific situation.

Delivery Method: Once enrolled and approved, your PERSERIS will be dispensed through a pharmacy. Your healthcare provider will administer the injection at their office or clinic.

Reauthorization Requirements

Yearly re-enrollment is no longer required for the Copay Assistance Program. However, you must:

• Provide updated patient authorization each calendar year to continue receiving benefits
• Maintain your private health insurance coverage
• Continue to meet all other eligibility requirements

Your eligibility period runs from January through December each calendar year.

What If Your Application Is Denied

If you are not eligible for the INSUPPORT Copay Assistance Program, INSUPPORT states that they may be able to help you find assistance from other sources. Contact them directly at 1-844-467-7778 to discuss alternative options.

Contact Information

• Phone: 1-844-467-7778 (1-844-INSPPRT)
• Website: www.INSUPPORT.com
• Fax: 844-814-0669
• Email: enroll@insupport.com
• Language Services: Interpreters available; call the phone number above

Important Disclaimer

The INSUPPORT Copay Assistance Program is not a form of insurance. It is a copay assistance program designed to help eligible patients with out-of-pocket costs for PERSERIS. This guide provides general information based on program terms and conditions. For complete and current program details, eligibility requirements, and terms and conditions, visit www.INSUPPORT.com or contact INSUPPORT directly. Always discuss your specific situation with your healthcare provider and insurance company to understand your coverage and costs.