Co-Pay Assistance Program

Co-Pay Terms and Conditions

The value of this program is exclusively for the benefit of enrolled patients and is intended to be used towards the patient out-of-pocket obligations, including applicable co-payments, co-insurance, and deductibles.* Patient may not seek reimbursement for the value received from this program from other parties, including any health insurance program or plan, flexible spending account or health care savings account. Patient is responsible for complying with any applicable limitations and requirements of his/her health plan related to the use of the program. Program is not valid where prohibited by law. Valid only in the United States and U.S. Territories. This program is not health insurance. This program may not be combined with any third-party rebate, coupon or offer. Offer is not available to patients whose prescription claims are eligible to be reimbursement, in whole or in part, by any government program, such as patients enrolled in Medicare Part D and patients whose prescription is paid for by Medicare, Medicaid, Medigap, CHAMPUS, Department of Defense (DoD), TRICARE, Veterans Affairs (VA), Children’s Health Insurance Program (CHIP), the Indian Health Service, or a state pharmaceutical assistance program. This program is not intended for the benefit of third parties who reduce the amount available to the patient, dilute the impact of the assistance available, or take a portion for their own purposes. Patients with health plans that redirect Blueprint Medicine program assistance intended for patient out-of-pocket costs or deceptively misrepresent coverage eligibility may be subject to alternate program benefit structures and terms at Blueprint Medicine’s sole discretion. Blueprint Medicines reserves the right to rescind, revoke, or amend the program and discontinue support at any time without notice. The maximum annual patient benefit under the program is $25,000. Offer is not valid if the patient is uninsured or paying cash for the prescription. If you have any questions, please contact customer support at 1-888-BLUPRNT (1-888-258-7768).

*Qualifying out-of-pocket expenses include co-pays, co-insurance, and deductibles as allowed by your health insurance provider.