XEOMIN

Indicated For

Cervical dystonia, blepharospasm

About This Medication

# XEOMIN Patient Assistance Program Patient Guide: How to Get XEOMIN (incobotulinumtoxinA) at Low or No Cost ## About XEOMIN (incobotulinumtoxinA) **XEOMIN** is a prescription medicine injected into muscles and used to improve the look of **moderate to severe frown lines** between the eyebrows (glabellar lines) in adults under 65 years of age, treat **cervical dystonia** (increased muscle stiffness in the neck), **blepharospasm** (increased muscle contraction around the eyes), and other conditions as approved by the FDA. It works by blocking nerve signals to muscles, temporarily reducing muscle activity. XEOMIN is a purified form of botulinum toxin type A, free of complexing proteins found in some other similar treatments. Always consult your doctor to see if XEOMIN is right for you, as it carries risks like muscle weakness, vision problems, or allergic reactions. This guide focuses on the **XEOMIN Patient Assistance Program (PAP)** from **Merz Pharmaceuticals, LLC**, which provides XEOMIN at **no cost** to eligible uninsured or underinsured patients.[1][2][3] ## Who Qualifies for the XEOMIN Patient Assistance Program? The program is designed for patients who cannot afford their medication due to financial hardship. Key qualifications include: - **Financial need**: Household income at or below **400% of the Federal Poverty Level (FPL)**. This is based on current Federal Poverty Guidelines, which adjust annually. - **Residency**: Must live in the **US or Puerto Rico**. - **Age and medical criteria**: Meet specific medical guidelines set by Merz, often for FDA-approved uses. - **Insurance status**: Uninsured or underinsured, with **no government coverage** (details below). Eligibility is **not guaranteed** and must be **re-established every 12 months**. Merz can change criteria or end assistance at any time. Changes in income or insurance must be reported within 30 days.[1][2][5][9] ## Income Eligibility Breakdown Income limits are set at **400% FPL** for your household size. Here's a patient-friendly table based on 2025-2026 Federal Poverty Guidelines (check HHS.gov for the latest, as they update yearly): | Household Size | Annual Income Limit (400% FPL) | |----------------|-------------------------------| | 1 (Individual) | $60,240 | | 2 (Couple) | $81,760 | | 3 | $103,280 | | 4 | $124,800 | *Add ~$21,520 per additional person.* Proof of all household income is required. Use pay stubs, tax returns, or benefit statements. This threshold helps ensure aid goes to those truly in need.[1][9] ## Insurance Requirements The program is for **uninsured or underinsured patients**. You **must not** have: - **Medicare**, Medicare Advantage, Medicare Part D - **Medicaid** - **Medigap** - **TRICARE**, Veterans Affairs (VA), or Department of Defense programs If underinsured (some commercial coverage), your **doctor must follow specific steps** before approval, like prior authorization attempts. Government insurance makes you ineligible—notify the program immediately if your status changes. Note: There's a separate **Patient Savings Program** for commercially insured patients (up to $5,000/year savings), but this guide covers the PAP for no-cost access.[1][2][5][9] ## Step-by-Step Application Process Applying is straightforward with **multiple methods**. Work with your doctor! 1. **Talk to your doctor**: Confirm XEOMIN is prescribed and discuss insurance steps if underinsured. 2. **Gather documents**: - Completed **enrollment form** (download from merzconnect.com or call). - **Proof of income** (e.g., 2025 tax return, recent pay stubs, W-2s for all household). - **Proof of insurance status** (insurance card, denial letter, or statement of no coverage). 3. **Submit**: - **Phone**: Call **(855) 463-7989** (1-855-4MERZTX, option 4), Mon-Fri 8am-7pm ET. A MERZ CONNECT specialist helps.[1][8] - **Fax**: Enrollment form to 855-825-0488.[9] - Doctor can submit for you. 4. **Wait for approval**: If approved, XEOMIN ships **directly to you**.[9] ## Timeline and Delivery **Processing time** varies but aim for quick turnaround—call for status. Once approved, medication is **shipped to the patient** at no cost. **Reauthorization** is required **every 12 months**; your doctor may need to resubmit. Refills follow the same process. Track via phone support.[1][2] ## Alternatives if Denied - **Appeal**: Contact MERZ CONNECT at (855) 463-7989 to review denial reasons (e.g., income too high, insurance issue). - **Patient Savings Program**: If commercially insured, save up to $5,000/year (call same number).[2][3] - **Other PAPs**: Check rxassist.org or NeedyMeds.org for similar programs. - **State assistance**, generic options, or low-cost clinics. - Discuss with your doctor about biosimilars or alternatives (none specified for XEOMIN).[6] ## Important Disclaimer This guide is for informational purposes only and based on publicly available program details as of 2026. **Merz Pharmaceuticals sets all criteria**; eligibility isn't guaranteed. Program terms can change—always verify with (855) 463-7989. Not health insurance. Report changes promptly. Consult your healthcare provider for medical advice. Acceptance doesn't mean indefinite help; it may end anytime. See full terms on merzconnect.com.(Word count: 942)[1][2][3][5][9]

Program information last verified: March 30, 2026