To submit a medical copay claim on behalf of a patient, you will need to provide:
Along with one of the following documents:
Please note: Claims submitted to the program must be for a patient with commercial insurance who is actively enrolled in the ONWARD Copay Program. Claims reimbursed under federally funded or state-funded healthcare programs are not eligible for reimbursement (including, but not limited to, Medicare [Part D and Medigap], an employer-sponsored health plan for Medicare-eligible retirees, Medicaid, any state pharmaceutical assistance program, TRICARE, VA, or DoD).