Am I eligible for Sunovion Support® prescription assistance?
It's easy to find out if you or someone you care for may qualify for the Sunovion Support® Prescription Assistance Program. If you can answer "yes" to the statements below, you may be eligible to participate in this Program. Sunovion reserves the right to modify the Sunovion Support® program at any time.
Are you or someone you care for:
- A resident of the United States, Puerto Rico, or the U.S. Virgin Islands, and 18 years of age or older
- Under the care of a U.S. healthcare professional with a valid prescription
- Without prescription insurance coverage (this includes Medicare and Medicaid)
- Within 300% of the federal poverty level for the number of people in your/their household
For the most current income thresholds or for more information see: https://aspe.hhs.gov/poverty-guidelines
If you answered "yes" to all of the questions above you may be eligible for our program. If you or someone you care for would like to apply for assistance, please download the application form below.
Download Aptiom® (eslicarbazepine acetate) application form Click Here
Please see APTIOM Medication Guide and Full Prescribing Information.
Mail the completed application form, your prescription, and proof of income to:
Sunovion Support®
PO Box 220285, Charlotte, NC 28222-0285
Or FAX to: 1-877-850-0821