As a caregiver, you may want to help the person you're caring for through the application process. It's important to find out how the person you care for could receive up to 12 prescription fills (equivalent to 12 months of assistance annually) of medication at no cost. Here's how you can help.
It's easy to apply for Sunovion Support®. Just follow the 5 easy steps below. If you have a question at any point in the process, please call the toll-free number at 1-877-850-0819 to speak with a Sunovion Support® Specialist.
Click here to check the patient's eligibility.
There are several ways to get an application form. It can be found via the eligiblity link above, or by calling the toll-free number at 1-877-850-0819 and speaking with a Sunovion Support® Specialist.
You will need to include proof of income with the application form
Please include information about the patient's household annual income and proof of income with the application form. (For example: Most recent federal tax return/1040 form/1040EZ form or Social Security Statement).
- If patient has not filed a Federal Tax Return, they can request a free Verification of Non-Filing by visiting www.IRS.gov and click on "Order a Transcript" or call 1-800-908-9946. Use Form 4506-T and check box 7 to request Verification of Non Filing.
The healthcare professional must fill out their section of the application form and sign it. Include the patient's prescription when sending in the application.
Mail the application form, with required documents, in an envelope to the address below:
Each application is checked to see if the applicant qualifies for the Program. Forms must include all requested documents to be complete.
The Program will contact you and your healthcare professional if you qualify or if the application form is missing information or documents.
Please note that the patient is free to switch their healthcare professional at any time while participating in the program. If you do switch your healthcare professional, please contact the program. It will not affect their eligibility for prescription assistance. Sunovion Support® is offered to them regardless of which healthcare professional or pharmacy they choose.
If it's easier, FAX your application and other documents to: 1-877-850-0821
Please call the toll-free number to speak with a Sunovion Support® Specialist.
8:00am to 8:00pm, EST
Monday through Friday
Sunovion reserves the right to modify or revoke this program at any time.