Eligibility criteria for patients enrolled in Medicare Part D

Eligibility Requirements

In order to be eligible for the program, you must meet the following requirements:

  • Must be a resident of the U.S. or U.S. Territories

    You must be a resident of the U.S. or U.S. territories and be under the care of a licensed healthcare provider authorized to prescribe, dispense and administer medicine in the U.S. or U.S. territories

  • Must have an annual household income of ≤400%

    You must have an annual household income of ≤400% of the current Federal Poverty Level. If you may be eligible for Medicaid, you will be required to provide documentation of Medicaid denial before being assessed for patient assistance eligibility

View Financial Eligibility Information

Download the Sanofi Patient Connection Application

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Download the Program Brochure