Financial Assistance Programs

XEOMIN Patient Assistance Program*

Merz is proud to offer a Patient Assistance Program (PAP) that provides XEOMIN® (incobotulinumtoxinA) at no charge to eligible patients. XEOMIN is available at no charge to patients who:

  • Are uninsured or underinsured
  • Meet financial eligibility requirements (based on the Federal Poverty Guidelines)
    • Documentation of income is required
    • Eligibility will be determined prior to the first injection for both uninsured and underinsured patients
  • Are US residents
  • Are not eligible for Medicare, Medicaid, or any other government program
  • Meet specific medical and clinical criteria as determined by Merz
  • Re-establish eligibility every 12 months

For underinsured patients, the physician must follow the steps below before drug at no charge will be provided unless otherwise instructed by the XEOMIN reimbursement support staff:

  • File a clean claim with the payor
  • Receive a claim denial
  • Appeal the denial
  • Receive a denied appeal
  • Provide documentation of the denied appeal to Merz

*Merz North America, Inc. reserves the right to modify or discontinue any and all aspects of the program at any time and without notice.

Criteria for the Patient Assistance Program (PAP) are established by Merz North America, Inc. Acceptance into the program does not entitle patients to receive assistance indefinitely. Eligibility must be re-established every twelve (12) months and assistance under the program may be terminated at any time. Changes in the status of the patient’s eligibility (such as changes in income and health coverage) should be reported to the Merz Neurosciences Patient Assistance Program within 30 days. Please see the Patient Assistance Program application for additional details.