Patient assistance from Janssen is available if you have commercial, employer-sponsored, or government coverage (e.g., Medicare, Medicaid, TRICARE, US Department of Veterans Affairs Health Care, US Department of Defense Health Care, etc.) that does not fully meet your needs and are not supported by other Janssen Access & Affordability options. You may be eligible to receive your prescribed Janssen medication free of charge for up to one year.
Ready to get started?
See the resources below:
Quick Reference Guide
Review this guide to learn more about Janssen’s patient assistance offering, including details on eligibility, eligible Janssen medications, and a step-by-step guide to help you navigate the process.
Download the Quick Reference Guide for Pulmonary Hypertension medications
Download the Quick Reference Guide for all other medications
Patient Enrollment Form
Work with your Health Care Provider to complete and submit this form. Once received, we will determine your insurance coverage, needs and eligibility to match you with a Janssen program that may be able to help.
Download the Patient Enrollment Form for Pulmonary Hypertension medications
Download the Patient Enrollment Form for all other medications
Patient Authorization Form
If you do not complete the Patient Authorization as part of the Patient Enrollment Form, you can sign and submit this form separately.
Click here to electronically sign and submit the Patient Authorization Form for Pulmonary Hypertension medications
Click here to electronically sign and submit the Patient Authorization Form for all other medications
If you have any questions or need additional assistance, please contact us at 1-833-742-0791.