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BMS Oncology Co-Pay Program

Helping Support Access for Eligible, Commercially Insured Patients

Bristol-Myers Squibb is committed to supporting access to YERVOY. That's why we've created the BMS Oncology Co-Pay Program. It's designed to help eligible patients who are being treated with YERVOY with out-of-pocket co-pay or co-insurance costs.

  • How Will This Program Help Me?
    • You are responsible for:
      • The first $50 of your co-pay (per infusion)
      • 5% of any remaining amount above $5,000 per year
      Bristol-Myers Squibb will support you with:
      • 100% of your co-pay or co-insurance costs above $50 (up to $5,000 per year)
      • 95% of the remaining costs, if your out-of-pocket expenses exceed $5,000 per year
      Program limit:
      • The Program has a maximum benefit of $25,000 per year
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  • Am I Eligible for the Program?
    • You may be eligible for the Program if you:
      • Are 18 years of age or older
      • Have commercial (private) insurance
      • Have been prescribed YERVOY for a Food and Drug Administration (FDA) approved indication
      • Are a U.S. resident
      • Have an annual household income of less than $100,000
      You may NOT be eligible if you:
      • Participate in a federal or state government-related healthcare program that pays in whole or in part for prescription drugs such as Medicare, Medicaid, TRICARE, or VA programs
      • Are a U.S. resident who resides or receives treatment in Massachusetts, where this offer is not valid
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  • How Do I Enroll?
    • Tell your oncologist or another healthcare team member that you are interested in enrolling in the BMS Oncology Co-Pay Program. Your oncologist’s office may be able to assist you with the enrollment process. Close
  • What If I Don’t Qualify?
    • Your oncologist can work with BMS Access Support™ counselors to identify other potential programs if you do not qualify for the BMS Oncology Co-Pay Program. Your oncologist can find more information at www.bmsaccesssupport.com and may be able to assist you with the enrollment process. Close
  • Are There Restrictions to the Program?
    • The Program will cover the co-pay costs of YERVOY only. It does not cover the costs of any other healthcare provider charges or any other treatment costs. Patients may be responsible for deductibles and other out-of-pocket costs, depending on their specific healthcare benefits.

      Other restrictions may apply based on the terms and conditions of the BMS Oncology Co-Pay Program listed below. Close
  • What Are Some FAQs About the Program?
    • Q.

      How do I enroll in the BMS Oncology Co-Pay Program?

      A.

      Your oncologist’s office is responsible for enrolling you in the program. This can be done by contacting BMS Access Support™. Please note that the enrollment form will require you and your physician’s signature.

      Q.

      What happens if I already paid my co-pay prior to being enrolled in the program?

      A.

      You may enroll in the program retroactively, this means you may be reimbursed for payments you’ve already made. Have your oncologist contact BMS Access Support™ for more information.

      Q.

      How quickly will the co-pay be received?

      A.

      If you are being treated with YERVOY, the co-pay is processed by BMS Access Support™ in 5-7 business days from the time the claim is received.

      Q.

      Who receives payments, the oncologist’s office or me?

      A.

      For YERVOY, your oncologist’s office must submit the claim, the office that submitted the claim will receive the payment. If your physician certified that he/she accepted payment of co-pay from you, the check will be sent to you.

      Q.

      Is there an income restriction?

      A.

      Yes, you must have an annual household income of less than or equal to $100,000. Some co-pay assistance may be available for patients with a household income of more than $100,000. Please have your oncologist contact BMS Access Support™ for additional details.

      Close
  • What Are the Full Terms and Conditions of the Program?
      • The patient must pay the first $50 of co-pay for each infusion. This Program will cover the remaining out-of-pocket co-pay for up to 4 infusions of YERVOY, and up to a maximum of $5000. Any costs exceeding the maximum of $5000 per year, the patient is responsible for 5% of the remaining out-of-pocket expenses. The program will then pay 95% of the remaining out-of-pocket expenses. The program will contribute a maximum of $25,000 per year, per patient.
      • This Program will cover the co-pay costs of YERVOY only. It does not cover the cost of the infusion or any other healthcare provider charges or any other treatment costs.
      • The Program may apply to retroactive co-pays for outpatient infusions of YERVOY that occurred within 120 days prior to the date of enrollment, subject to the Program maximum of $25,000.
      • This offer is not valid for patients whose prescriptions are covered by a federal or state government-related healthcare program which pays in whole or in part for prescription drugs such as Medicare, Medicaid, TRICARE or VA Programs or where the entire cost of the prescription is covered by commercial insurance. Patients may not submit a claim for reimbursement under any of these programs.
      • If you have commercial insurance, your acceptance of this offer confirms that the offer is consistent with your insurance and that you will report the value of the co-pay assistance you receive as may be required by your insurance provider. Patients must not seek reimbursement from any healthcare reimbursement accounts or flexible spending accounts. Patients who move from commercial to federally-funded insurance will no longer be eligible for the Program.
      • Patients must have an annual household income of $100,000 or less. Some assistance may be available to patients with household incomes of >$100,000, on a case-by-case basis
      • Patients must enroll by December 31, 2013. Once a patient is enrolled in the program, the program will cover all doses (maximum of 4) in accordance with the FDA-approved YERVOY package insert.
      • Explanation of Benefits (EOB) must be submitted within 180 days post-infusion to receive co-pay assistance.
      • Proof required for payment must be a valid Explanation of Benefits (EOB) with YERVOY code-specific information. An EOB must be submitted regardless of assigned J Code.
      • This offer is valid only in the United States and Puerto Rico.
      • This offer is not valid for residents of Massachusetts or for infusions received in Massachusetts.
      • This offer is not an insurance benefit.
      • This offer is void where prohibited by law, taxed, or restricted.
      • This offer may not be combined with any other offer, rebate, coupon, or free trial.
      • This offer is non-transferrable.
      • This is a limited time offer. Bristol-Myers Squibb reserves the right to rescind, revoke, amend, or terminate this offer or the program in its entirety at any time.
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Important Safety Information

YERVOY (ipilimumab) can cause serious side effects in many parts of your body which can lead to death. These serious side effects may include: inflammation of the intestines (colitis) that can cause tears or holes (perforation) in the intestines; inflammation of the liver (hepatitis) that can lead to liver failure; inflammation of the skin that can lead to severe skin reaction (toxic epidermal necrolysis); inflammation of the nerves that can lead to paralysis; inflammation of hormone glands (especially the pituitary, adrenal, and thyroid glands) that may affect how these glands work; and inflammation of the eyes.

These side effects are most likely to begin during treatment; however, side effects can show up months after your last infusion. Your healthcare provider should perform blood tests, such as liver and thyroid function tests, before starting and during treatment with YERVOY. Your oncologist may decide to delay or stop YERVOY.

Call your healthcare provider if you have any signs or symptoms or they get worse. Even seemingly mild symptoms can lead to severe or even life-threatening conditions if not addressed. Do not try to treat symptoms yourself.

Serious side effects may include:

  • Inflammation of the intestines (colitis) that can cause tears or holes (perforation) in the intestines. Signs and symptoms of colitis may include:
    • diarrhea (loose stools) or more bowel movements than usual
    • blood in your stools or dark, tarry, sticky stools
    • stomach pain (abdominal pain) or tenderness
  • Inflammation of the liver (hepatitis) that can lead to liver failure. Signs and symptoms of hepatitis may include:
    • yellowing of your skin or the whites of your eyes
    • dark urine (tea colored)
    • nausea or vomiting
    • pain on the right side of your stomach
    • bleeding or bruise more easily than normal
  • Inflammation of the skin that can lead to severe skin reaction (toxic epidermal necrolysis). Signs and symptoms of severe skin reactions may include:
    • skin rash with or without itching
    • sores in your mouth
    • your skin blisters and/or peels
  • Inflammation of the nerves that can lead to paralysis. Symptoms of nerve problems may include:
    • unusual weakness of legs, arms, or face
    • numbness or tingling in hands or feet
  • Inflammation of hormone glands (especially the pituitary, adrenal, and thyroid glands) that may affect how these glands work. Signs and symptoms that your glands are not working properly may include:
    • persistent or unusual headaches
    • unusual sluggishness, feeling cold all the time, or weight gain
    • changes in mood or behavior such as decreased sex drive, irritability, or forgetfulness
    • dizziness or fainting
  • Inflammation of the eyes. Symptoms may include:
    • blurry vision, double vision, or other vision problems
    • eye pain or redness

Pregnancy and Nursing:

  • Tell your healthcare provider if you are pregnant or plan to become pregnant. YERVOY may cause stillbirth, premature delivery, and/or death of your unborn baby. Before starting YERVOY, tell your healthcare provider if you are breast-feeding. It is advised that nursing mothers do not breast feed while taking YERVOY.

Tell your healthcare provider about:

  • Your health problems if you:
    • have an active condition where your immune system attacks your body (autoimmune disease), such as ulcerative colitis, Crohn's disease, lupus, or sarcoidosis.
    • had an organ transplant, such as a kidney transplant
    • have liver damage from diseases or drugs
    • have any other medical conditions
  • All the medicines you take including:
    • all prescription and non-prescription medicines
    • steroids or other medicines that lower your immune response
    • vitamins
    • herbal supplements

    You should not start a new medicine before you talk with your healthcare provider who prescribes you YERVOY.

Most Common Side Effects:

The most common side effects of YERVOY include: tiredness, diarrhea, itching, and rash.

These are not all of the possible side effects of YERVOY. If you have any questions about your health or medicines, talk to your healthcare provider.

Please see U.S. Full Prescribing Information, including Boxed WARNING regarding immune-mediated side effects, and Medication Guide for YERVOY.

The information provided on this website is not a substitute for talking to your healthcare provider. Your healthcare provider is the best source of information about your disease.

Models on this website are used for illustrative purposes only.

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Scroll down or click here for detailed Important
Safety Information.

Indication

YERVOY (ipilimumab) is a prescription medicine used in adults to treat melanoma (a kind of skin cancer) that has spread or cannot be removed by surgery.

It is not known if YERVOY is safe and effective in children less than 18 years of age.

Select Safety Information

YERVOY (ipilimumab) can cause serious side effects in many parts of your body which can lead to death. These serious side effects may include: inflammation of the intestines (colitis) that can cause tears or holes (perforation) in the intestines; inflammation of the liver (hepatitis) that can lead to liver failure; inflammation of the skin that can lead to severe skin reaction (toxic epidermal necrolysis); inflammation of the nerves that can lead to paralysis; inflammation of hormone glands (especially the pituitary, adrenal, and thyroid glands) that may affect how these glands work; and inflammation of the eyes.

These side effects are most likely to begin during treatment; however, side effects can show up months after your last infusion. Your healthcare provider should perform blood tests, such as liver and thyroid function tests, before starting and during treatment with YERVOY. Your oncologist may decide to delay or stop YERVOY.

Call your healthcare provider if you have any signs or symptoms or they get worse. Even seemingly mild symptoms can lead to severe or even life-threatening conditions if not addressed. Do not try to treat symptoms yourself.

Please see detailed Important Safety Information, including Boxed WARNING regarding immune-mediated side effects.