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Celltrion Connect® Patient Support Program
SteQeyma®

Patient Assistance Program: STEQEYMA® (ustekinumab-stba) Definition, Rules and Eligibility, and Terms and Conditions

Patients Eligible for the Celltrion CONNECT® Patient Assistance Program (PAP)

The Celltrion CONNECT Patient Assistance Program (PAP) is designed to provide free product to qualified individuals who are uninsured. Celltrion CONNECT will help activate PAP for eligible participants.

To receive PAP benefits, the patient must enroll in the program and meet the following eligibility requirements:

  • Patient has no insurance:
    • Uninsured includes all payor types
    • The patient must have tried all other insurance options for coverage. Some examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy assistance programs, veterans assistance, and any other social service agency support.
    • This program excludes patients whose medication is reimbursed in whole or in part by any type of government insurance (e.g., Medicare, Medicaid, TRICARE, or any other federal or state program). Patients who have Medicare Parts A and B only (no Medicare Part D) are still excluded.
  • Patient must have a valid prescription from a licensed healthcare provider (HCP) for an on-label indication.
  • Patient must have an adjusted annual household income of <400% of the federal poverty level (FPL).
  • Income verification:
    • Electronic income verification (eIV) will be conducted by the program. No asset review will be required; however, patients will need to provide proof of income if eIV does not match what the patient has reported (proof of income could include one of the following: W-2s, tax returns (1040, 1099), 3 months of pay stubs).
  • Patient must show proof of residency by providing valid United States or the Commonwealth of Puerto Rico address, and product must be administered and shipped to locations in the United States or the Commonwealth of Puerto Rico. Patient must have lived in the United States or the Commonwealth of Puerto Rico for at least 6 months.
  • Diagnosis and dosing are consistent with FDA-approved indication for STEQEYMA.
  • Patients with insurance plans or employers participating in an alternate funding program (also sometimes referred to as patient advocacy programs, specialty networks, SHARx, Paydhealth, or PayerMatrix, among other names) are not eligible for PAP.
    • These programs require patients to apply to a manufacturer’s PAP or otherwise pursue specialty drug prescription coverage through an alternate funding vendor as a condition of, requirement for, or prerequisite to coverage of relevant products, or that otherwise denies, restricts, eliminates, delays, alters, or withholds any insurance benefits or coverage contingent upon application to, or denial of eligibility for, specialty drug prescription coverage through the alternate funding program.
    • Patients must promptly contact the Celltrion CONNECT PAP if their financial status or insurance coverage changes.
  • Electronic benefits verification (eBV) will be conducted by the program every 6 months to determine coverage changes.
  • You may not seek payment for the value of medicines received from this program from any health plan, patient assistance foundation, flexible spending account, or healthcare savings account
  • This program offer may not be used with any other coupon, discount, prescription savings card, free trial, or other offer. Offer good only in the United States or the Commonwealth of Puerto Rico. Void where prohibited, taxed, or limited by law. 
  • Program terms will expire at the end of each calendar year and may change or end without notice.
  • Eligibility rules are subject to change at any time.
  • Please see Full Prescribing Information.

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