EYLEA4U® can help your patients with the referral process


EYLEA4U e-Portal: Your one-stop, online destination for reimbursement and patient support
The EYLEA4U e-Portal is an efficient, secure, and convenient tool for enrolling and managing patients in our support programs. The portal is available online for instant access to patient case status updates.†
- †Requires registration and e-signature setup.
EYLEA4U Enrollment Form
Use the EYLEA4U Enrollment Form to request the specific support your patients need, including copay assistance.
Independent charitable foundations
Patients who need help paying for their EYLEA out-of-pocket costs can apply for assistance through independent charitable foundations, including the following*:
-
Good Days
1-877-968-7233 mygooddays.org -
Patient Access Network (PAN) Foundation
1-866-316-7263 panfoundation.org -
National Organization for Rare Disorders (NORD)
1-800-999-6673, ext. 219 rarediseases.org -
HealthWell Foundation
1-800-675-8416 healthwellfoundation.org
Regeneron does not influence or control the operations of independent charitable foundations and cannot guarantee assistance will be provided.
Get help from EYLEA4U
During referral to an independent charitable foundation, a Reimbursement Specialist:
- Verifies coverage and determines patient out-of-pocket costs for EYLEA
-
Contacts patient to discuss the referral process and independent charitable foundations with available funding for approved indications
- Provides information to assist patient with applying to the foundation chosen by the patient
- Follows up until outcome is determined
- Communicates with physician's office throughout the referral process

To get started with a referral, visit the EYLEA4U e-Portal or call EYLEA4U at 1-855-EYLEA4U (1-855-395-3248), Option 4, Monday–Friday 9 AM–8 PM Eastern Time.

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