Unlock Greater Savings on Follistim AQ
ReUnite Assist offers significant savings on Follistim AQ for self-pay patients. Eligible patients who qualify based on income may pay as little as $100 per 300 IU.
Eligible Medications
- Follistim AQ Cartridge (follitropin beta injection)
Eligibility Requirements
- Current proof of income (IRS 1040 tax form)
- Discount expires one year from the date issued
- Cannot be combined with other ReUnite program discounts
Application Instructions
- Apply Online for ReUnite Assist.
- Complete your personal information.
- Upload your IRS 1040 tax form.
- Submit your application. You will receive an email notification within 24-48 hours regarding your application status.
For more information about this program, call 1-800-515-3784 or email info@mdrusa.com.