I worked with the Cayston Access Program when my insurance wasn't covering CAYSTON. They helped me so I did not have to interrupt treatment.”
Assistance Programs | CAYSTON® (aztreonam for inhalation solution)
Trying to understand the complex world of healthcare reimbursement can be overwhelming. That's why Gilead has created the Cayston Access Program® (CAP).
The Cayston Access Program assists you with information about and access to CAYSTON. It is not required that you fill out the Cayston Access Program enrollment forms to receive CAYSTON—your doctor can prescribe CAYSTON for you without going through the Cayston Access Program. However, the Cayston Access Program can provide you with information that may help make it easier for you to understand reimbursement options for CAYSTON.
cayston access program form
To enroll in CAP, an application must be completed with your physician. The preferred method of submission is to fax the full completed form to the Cayston Access Program at 1-877-550-1705. An electronic signature can also be submitted at CAP.eHIPAA.com.
Download the Cayston Access Program Patient Authorization Form
Call CAP at 1-877-722-9786 8 AM – 8 PM EST, Monday through Friday with any questions.
HOW THE CAYSTON ACCESS PROGRAM CAN HELP YOU WITH:
- General Information—Our specialists can answer general questions you have about CAYSTON. CAP will also provide a welcome call for new patients to ensure they have received their CAYSTON and answer any questions as they get started.
- Insurance Verification—Our specialists can verify your health insurance benefits, assess your coverage for CAYSTON, help you through any prior authorization processes, and help clarify any co-payment obligations you may have.
- Financial Assistance—Our specialists can help identify financial support options to access CAYSTON.
- Specialty Pharmacy Referral—Your healthcare provider can send your CAYSTON prescription to the Cayston Access Program. We will work with your selected specialty pharmacy to follow up on your CAYSTON delivery.
- Claims Appeal Support—If your insurance claim is denied, our specialist can help identify the reason and share the information about the appeal process with your healthcare provider.
Financial assistance
People WITH PRIVATE INSURANCE AND CO-PAYS ABOVE $10
CAYSTON Co-pay Coupon Program
People with private insurance pay no more than $10 per fill. There is no monthly limit, but it is capped at 7 fills per calendar year up to a maximum value of $8000 annually.
eligibility
- Commercially insured
- Prescriptions are not paid for in part or in full by any state or federally funded program, including but not limited to Medicare or Medicaid, VA, DOD, or TRICARE
- Click here for additional Terms and Conditions
ALTERA® Co-pay Coupon Program
People on CAYSTON may be eligible to save up to $430 when they pay a $10 co-pay for purchase of an ALTERA Nebulizer System or ALTERA replacement unit. People are eligible to receive up to 2 per year. Contact CAP to use the ALTERA $10 co-pay coupon.
eligibility
- Commercially insured
- Prescriptions are not paid for in part or in full by any state or federally funded program, including but not limited to Medicare or Medicaid, VA, DOD, or TRICARE
- Click here for additional Terms and Conditions
People with government or private insurance needing extra financial support
Independent Third-party Foundation Referrals
For those who do not qualify for the CAYSTON co-pay coupon, the Cayston Access Program can refer them to available independent third-party foundations. Eligibility criteria may vary by Foundation.
eligibility
- Referral to an independent third-party foundation does not guarantee assistance.
- Foundations are independent from and unaffiliated with Gilead. Those who apply may need to provide additional information to apply for foundation assistance.
People with no insurance
The CAYSTON Patient Assistance Program
Provides assistance for those who are uninsured for CAYSTON.
eligibility
- Meet income requirements
- No insurance coverage
