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GOMEKLI™ (mirdametinib)
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844-CARES-55 (844-227-3755)Monday-Friday 8 AM-10 PM ET  844-227-3747
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Insurance Navigation & Financial Help  

We do not want concerns about cost or insurance coverage to come between you and your medication. Our team of Nurse Advocates are here to provide information about financial assistance options that may be available to you, as well as explain your insurance coverage, and help determine if GOMEKLI™ (mirdametinib) is covered.
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Copay Mob 2

If you have commercial health insurance, you may pay as little as a $0 copay per 21-day supply of GOMEKLI with the Commercial Copay Program.*

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Reimbursement for Eligible Treatment- Related Costs

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SpringWorks CareConnections may also help with eligible out-of-pocket costs for certain treatment-related tests, examinations, and/or specialty visits during treatment with GOMEKLI.*
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Patient Assistance Program (PAP)

If you are uninsured, lack coverage for GOMEKLI, or are experiencing financial hardship, the Patient Assistance Program may help you obtain GOMEKLI at no cost.†

* Terms and conditions apply. Copay program for GOMEKLI and reimbursement for eligible treatment-related costs are subject to annual benefit maximums. To receive the reimbursement of eligible treatment-related expenses, an Explanation of Benefits (EOB) form must be submitted, along with copies of receipts for any payments made. Full terms and conditions provided during enrollment process and are available upon request by contacting SpringWorks CareConnections at 844-CARES-55 (844-227-3755).
† Terms and conditions apply. PAP eligibility criteria and annual household income limits apply. Full terms and conditions provided during enrollment process and are available upon request by contacting SpringWorks CareConnections at 844-CARES-55 (844-227-3755).

Independent Patient Assistance Foundations

Financial assistance may be available through independent foundations that are not controlled by or otherwise affiliated with SpringWorks Therapeutics. These foundations may be able to assist with, for example, copays, premiums, patient education, and social services.

Explore additional foundations that may be able to help with financial assistance

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This link is created by Real Endpoints. Real Endpoints is independent of SpringWorks Therapeutics. SpringWorks Therapeutics is providing a link to these foundations to help patients find more information about potential assistance, but inclusion on this list does not represent an endorsement or a recommendation from SpringWorks for any group or organization. The organizations listed are independent of SpringWorks and SpringWorks does not influence or control the operations of independent patient assistance foundations. SpringWorks cannot guarantee assistance will be provided. Details and eligibility requirements can be found directly on the individual foundation websites.

Temporary Free Medication Programs for Eligible Patients

These programs may help you or your loved one if your insurance coverage is delayed, or you experience a gap in insurance coverage:

QUICK START PROGRAM

Available to eligible commercially insured patients and may help you or your loved one start on GOMEKLI at no cost for a limited period of time if your insurance company is delayed in making a coverage decision.‡
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Eligible patients experiencing a qualified delay in their insurance coverage may receive an initial 21-day supply of GOMEKLI, and up to 5 refills, subject to program terms.

If you are waiting to see if your insurance will cover GOMEKLI, talk to your doctor, or call one of our Nurse Advocates to learn more about the Quick Start Program.

BRIDGE PROGRAM

Available to eligible patients and may provide you or your loved one with GOMEKLI at no cost for a limited period of time if you experience an interruption or gap in coverage.‡
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Eligible patients experiencing a qualified loss, gap, lapse, or other interruption in their insurance coverage may receive an initial 21-day supply of GOMEKLI, and up to 2 refills, subject to program terms.

If you are currently on GOMEKLI and your insurance has changed, talk to your doctor, or call one of our Nurse Advocates to learn more about the Bridge Program.

‡ Terms and conditions apply. Full terms and conditions provided during enrollment process and are available upon request by contacting SpringWorks CareConnections at 844-CARES-55 (844-227-3755).
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844-CARES-55
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Monday-Friday
8 AM-10 PM ET

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C_GOM_US_0082  02/25

OGSIVEO is a registered trademark of SpringWorks Therapeutics, Inc. GOMEKLI and SpringWorks CareConnections are trademarks of SpringWorks Therapeutics, Inc. All other trademarks are the property of their respective owners.

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