Creature sitting next to a man on his tablet with the VELSIPITY (etrasimod) VELSIPITYForMe

Creature sitting next to a man on his tablet with the VELSIPITY (etrasimod) VELSIPITYForMe

Support to help you get started

Meet your Dedicated Care Coordinator

Once enrolled in VelsipityForMe, your Dedicated Care Coordinator will be your main point of contact and help guide you through getting started. Your dedicated care coordinator can:

Welcome you to VelsipityForMe and go over next steps.

Explain insurance coverage and identify potential financial assistance.

Schedule screening tests for eligible, commercially insured patients*

Communicate with you throughout the process and share important updates with your doctor.

*Eligibility required. Commercially insured patients only. Baseline assessment coordination services are not available for patients enrolled in a state or federally funded health insurance program, or for patients who reside in MI, MN, or RI.

Various screening support options for eligible, commercially insured patients

Before you start treatment with VELSIPITY, you will need to complete a few screening tests. You and your doctor will decide if these tests will happen in the doctor’s office or at your home. Your Dedicated Care Coordinator may be able to help schedule tests as needed.

At-Home Screening

VelsipityForMe can either arrange for a licensed clinician to visit your home or we can send a self-administered device to you with step-by-step instructions, based on screening needs.

Tests will be interpreted by a specialist and shared back with your doctor.

In-Office Screening

Your Dedicated Care Coordinator may be able to schedule near-term appointments for certain screening tests to be completed by a provider in an office setting.

Eligibility required. Baseline assessment coordination services are not available for patients enrolled in a state or federally funded prescription health insurance program, or patients who reside in MI, MN, or RI.

Reimbursement for In-Office Screening

If you and your doctor decide that all or some of the screenings will be completed in the office, there may be associated out-of-pocket costs.

Eligible patients may be reimbursed up to $2,500 for qualified out-of-pocket expenses. Terms and Conditions apply.

To submit for out-of-pocket expense reimbursement visit

velsipity.com/reimbursement

Eligible patients may be reimbursed up to $2,500 for qualified out-of-pocket expenses related to baseline assessments. Support may be available for patients after assessments have been completed at a provider’s office. Eligibility required. Commercially insured patients only. The baseline assessments medical benefit offer is subject to a maximum one-time benefit of $2,500 for qualified out-of-pocket expenses and includes initial blood tests, ECG screening, eye exam, and baseline skin examination where the full cost is not covered by patient’s insurance. Patients enrolled in a state or federally funded prescription health insurance program or who are residents of MN or RI are not eligible for the medical benefit. Available only to patients who have been diagnosed with an FDA-approved indication for VELSIPITY. No membership fees. This is not health insurance. Terms and Conditions apply.

Pay as little as $0 per month for your VELSIPITY prescription§

VELSIPITY (etrasimod) Copay Savings Cards

VELSIPITY (etrasimod) Copay Savings Cards

As part of our Copay Savings Program, eligible commercially insured patients may pay as little as $0 in out-of-pocket costs, with a maximum benefit of $4,000 to $16,000 per calendar year. See Terms and Conditions.
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§Eligibility required. Commercially insured patients only. The maximum prescription benefit offer per patient is $4,000 to $16,000 per calendar year. Patients enrolled in a state or federally funded prescription health insurance program are not eligible. No membership fees. This is not health insurance. Available only to patients who have been diagnosed with an FDA-approved indication for VELSIPITY. Visit VELSIPITY.com for full Terms and Conditions.

Not enrolled in VelsipityForMe?

Request support from a Dedicated Care Coordinator today.

Get Support

Receive up to 2 years of medication at no
cost, shipped through Interim Care Rx

If a delay or coverage denial occurs during the prior authorization or appeals process, eligible, commercially insured patients enrolled in VelsipityForMe may receive free VELSIPITY for up to 2 years, shipped to you through Interim Care Rx. See Terms and Conditions.

Eligibility required. Not available for residents of MA, MI, MN, or RI. See Terms and Conditions.

No Insurance or Underinsured?

If you have no insurance and need financial assistance, we will refer you to Medicaid if you appear to be eligible. If turned down, we will evaluate you for the Pfizer Patient Assistance Program. If you are eligible, we will provide you VELSIPITY at no cost to you.

See Terms and Conditions.