YUTIQ

Indicated For

chronic non-infectious uveitis affecting the posterior segment of the eye

About This Medication

# YUTIQ AccessPlus Patient Assistance Program Patient Guide: How to Get YUTIQ at Low or No Cost YUTIQ (fluocinolone acetonide intravitreal implant) 0.18 mg is a prescription eye implant that releases medication for up to **36 months** to treat chronic non-infectious uveitis affecting the back of the eye.[10] The **YUTIQ AccessPlus Patient Assistance Program** from Alimera Sciences, Inc. provides free YUTIQ to eligible uninsured or underinsured patients who meet income requirements.[1][3] ## About YUTIQ **YUTIQ** is a tiny, sustained-release implant inserted into the eye by a retina specialist. It delivers fluocinolone acetonide, a corticosteroid, directly to treat inflammation from chronic non-infectious uveitis in the posterior segment (back) of the eye. This condition can cause vision loss if not managed, with symptoms like blurred vision, floaters, or pain.[10] Unlike eye drops, YUTIQ provides consistent dosing for up to three years, reducing the need for frequent treatments.[10] It's for adults with this specific diagnosis—talk to your doctor to confirm if it's right for you. Common side effects include cataracts, increased eye pressure, and vitreous floaters; serious risks involve infection or retinal detachment. Always follow your doctor's guidance.[10] ## Who Qualifies for the Program? The program helps **uninsured or underinsured patients** facing high out-of-pocket costs for YUTIQ.[1][5] You must have a valid prescription from a licensed prescriber, typically a retina specialist. Income eligibility is based on household income, but **exact Federal Poverty Level (FPL) thresholds are not publicly specified**—income details are required, and proof may be requested during review.[1] Alimera verifies eligibility, which may include checking financial, insurance, and medical info.[1][2] U.S. residency is implied for participation. The program can change or end anytime.[1] ## Income Eligibility Breakdown Specific income limits aren't detailed in program materials, but applications require Social Security number and income disclosure for verification.[2] Proof like tax returns or pay stubs may be needed.[1] Here's a general overview: | Household Size | Estimated Eligibility | Notes | |---------------|----------------------|-------| | Individual | Income info required; proof may be requested | No fixed FPL % listed[1] | | Couple | Income info required; proof may be requested | Household total considered[1] | | Family of 3 | Income info required; proof may be requested | Adjustments for dependents[1] | | Family of 4+ | Income info required; proof may be requested | Full household income verified[1] | Contact the program for your situation, as guidelines evolve.[3][7] ## Insurance Requirements Designed for **uninsured or underinsured patients** without YUTIQ coverage or with unaffordable costs.[1][5] If you have insurance, notify AccessPlus of changes—the program may assist with benefits investigation or appeals first.[1][4] Medicare patients may qualify if lacking coverage, but confirm via phone.[5] Commercial insurance users might access copay help separately (not this PAP).[9] ## Step-by-Step Application Process 1. **Get a Prescription**: Ask your retina specialist for YUTIQ and discuss the AccessPlus Program.[6] 2. **Download the Form**: Get the two-page PAP application from the HCP site (hcp.yutiq.com) or call for help.[1][6] 3. **Complete All Fields**: Fill out patient info, diagnosis, prescriber details, income (SSN required), insurance status, and sign authorizations. Both pages must be complete.[1][2] 4. **Gather Documents**: - Completed application - Proof of income (if requested: pay stubs, tax returns) - Prescriber signature/info - Patient authorization/release (HIPAA form expires in 3 years unless revoked)[1][2] 5. **Fax It In**: Send to **1-866-783-3124**. Use phone **(844) 445-8843** for questions.[1][5][6] 6. **Wait for Review**: Alimera/ConnectiveRx processes; they may contact you or your doctor.[1] 7. **Receive Medication**: If approved, YUTIQ ships free to your home or doctor's office.[1] Sign the authorization allowing info sharing for program admin, coverage review, and assistance.[1][2] ## Timeline and Delivery Processing time isn't specified—call **(844) 445-8843** for status updates.[6] Once approved, delivery is direct to patient or physician office at no cost.[1] Notify immediately of insurance/income changes.[1] Implants are single-use; track expiration. ## Alternatives if Denied - **Appeal**: Resubmit with more docs or updated info.[1] - **Copay Programs**: Commercial insurance? Check YUTIQ Copay (pay as low as $25/fill, up to $9,000/year).[9] - **Other PAPs**: Search rxassist.org for uveitis options.[3][7] - **Manufacturer Support**: Call AccessPlus for benefits investigation or appeals.[4][8] - **Financial Aid**: Local clinics, nonprofits, or state programs for eye care. No biosimilars listed for YUTIQ.[ ] ## Important Disclaimer This guide summarizes publicly available info as of latest sources—**program details can change**.[1][3] Alimera reserves rights to modify/cancel anytime without notice.[1][2] Not medical/financial advice. Consult your doctor and call **(844) 445-8843** to verify eligibility. Revoke authorization anytime in writing to Alimera Sciences, AccessPlus, c/o ConnectiveRx, 6000 Park Lane Dr, Pittsburgh, PA 15275 or fax 1-866-783-3124.[1] YUTIQ has risks; discuss with your provider.[10] (Word count: 942)

Program information last verified: March 30, 2026