Prevymis

Indicated For

CMV prophylaxis in transplant patients

About This Medication

# Merck Access Program Patient Guide: How to Get Prevymis (letermovir) at Low or No Cost ## About Prevymis Prevymis (letermovir) is a prescription medication available in 240 mg and 480 mg tablets, as well as oral pellets in 20 mg and 120 mg strengths. If you have been prescribed Prevymis by your healthcare provider but are concerned about the cost, the Merck Access Program may be able to help you access this medication at no cost. ## Who Qualifies for the Merck Access Program The Merck Access Program is designed primarily for uninsured patients who cannot afford their medications. However, the program also considers underinsured individuals and those facing financial hardship. To qualify, you must meet all of the following requirements: - You are a U.S. resident (including Puerto Rico) - You have a valid prescription for Prevymis from a licensed U.S. healthcare provider - You meet the program's income and financial need criteria - You are either uninsured, underinsured, or facing documented financial and medical hardship If you don't meet standard insurance criteria, you may still qualify if you can demonstrate special circumstances of financial and medical hardship and your income falls within the program's guidelines. ## Income Eligibility The Merck Access Program uses a needs-based approach to determine eligibility rather than strict income cutoffs. This means the program evaluates your individual financial situation to determine if you qualify for assistance. Income limits vary by state, and special considerations apply for Alaska and Hawaii. To learn your specific income eligibility threshold, contact the Merck Access Program directly at (855) 404-5278. Program representatives can discuss your financial situation confidentially and help determine if you qualify. ## Insurance Requirements The program is available to: - **Uninsured patients**: Those with no health insurance coverage - **Underinsured patients**: Those with insurance but facing high out-of-pocket costs, copayments, or deductibles - **Patients with financial hardship**: Those who can document special circumstances of financial and medical hardship If you have Medicare, Medicaid, or other insurance, you may still be eligible if your out-of-pocket costs are prohibitively high. The program can help investigate your insurance benefits and assist with prior authorization or appeals processes. ## How to Apply: Step-by-Step ### Step 1: Gather Required Documents Before starting your application, collect the following: - Your valid prescription for Prevymis from your healthcare provider - Proof of income (recent pay stubs, tax returns, or benefit statements) - Proof of residency (utility bill, lease agreement, or government-issued ID) - Insurance information if applicable (insurance card front and back) ### Step 2: Complete the Enrollment Form You have two options for completing the enrollment form: **Online Application**: Visit the Merck Access Program website and complete the enrollment form electronically. This is the fastest method. **Paper Application**: Download and print the enrollment form, complete it by hand, and submit it by fax or mail. ### Step 3: Submit Your Application **Online**: Submit your completed form directly through the online portal at the Merck Access Program website. **By Fax**: Fax your completed form to (866) 866-4127 **By Mail**: Mail your completed form to: The Merck Access Program PO Box 2349 Columbus, OH 43216 ### Step 4: Work with Your Healthcare Provider Your healthcare provider can also assist with the application process. They can complete a Healthcare Provider Enrollment Form and submit it along with your patient form. Your provider's involvement helps ensure the program has all necessary medical information. ## Application Timeline and Medication Delivery While specific processing times are not published, the Merck Access Program works to process applications as quickly as possible. Once approved, your medication will be shipped directly to you or to your healthcare provider's office, depending on what was arranged during the application process. Approval is valid for up to 12 months from the date of approval. You will need to reapply annually to continue receiving assistance. ## What Happens If Your Application Is Denied If your application for the Merck Access Program is denied, you have several options: - **Request clarification**: Contact the program to understand why you were denied and whether additional information could support your eligibility - **Explore co-pay assistance**: The Merck Access Co-pay Assistance program may be available if you have insurance but face high out-of-pocket costs - **Discuss alternatives with your provider**: Your healthcare provider may know of other resources or assistance programs - **Reapply**: If your financial circumstances change, you can submit a new application ## Reauthorization and Refills Your approval through the Merck Access Program is valid for 12 months. Before your approval expires, you will need to submit a new application to continue receiving medication at no cost. You can reapply as many times as needed, and the program encourages patients to do so if they continue to meet eligibility criteria. ## Contact Information **Phone**: (855) 404-5278 **Hours**: Monday–Friday, 8 AM–8 PM ET **Fax**: (866) 866-4127 **Mailing Address**: The Merck Access Program, PO Box 2349, Columbus, OH 43216 Program representatives are available to answer questions about eligibility, the application process, and program benefits. For income limits in Alaska and Hawaii, call (1-800) 727-5400. ## Important Disclaimer This guide provides general information about the Merck Access Program for Prevymis. Program eligibility, requirements, and benefits may change. For the most current and accurate information, contact the Merck Access Program directly or visit the official program website. This information is not a guarantee of eligibility or approval. Your healthcare provider should confirm that Prevymis is medically appropriate for your condition.

Program information last verified: March 30, 2026