First Steps Form

For thousands of Americans suffering with infertility, one of the first steps before seeking treatment is figuring out how to pay for it. Unfortunately, it is estimated that over 50% of patients who seek treatment do not have any level of fertility medical or drug coverage.

To aid some of these patients with drug cost, DesignRx has created First Steps, a patient financial assistance program.


Patient Enrollment

  1. Download the Application or call 1-855-672-9260 to have it emailed to you.
  2. Complete First Steps application, and sign patient authorization form.
  3. Send First Steps application, patient authorization form, and required income verification documents to First Steps customer service using one of the following methods:

    Mail
    Envision Rx Options
    First Steps 2181
    E. Aurora Road Suite 201
    Twinsburg, OH 44087

    Fax 1-855-672-9262
    Email: This email address is being protected from spambots. You need JavaScript enabled to view it.


 

First Steps Program Details:

  • The First Steps program takes into consideration household income and hardship cases to provide eligible patients with a 5%, 25%, 50%, or 75% discount off their fertility drug cost.
  • Discounts are reserved for 100% cash pay patients only
  • Discounts will be applied to the DesignRx cash price at participating DesignRx pharmacies
  • Discounts cannot be combined with any other rebate, coupon, free trial, or similar offer.
  • Discounts are valid for up to one year from the date they were initially approved
  • Eligible patients will receive an approval email with specific instructions on how to redeem discounts
  • Patients not qualifying for a discount will still be eligible for DesignRx pricing at DesignRx pharmacies only
  • DesignRx pricing alone is consistently 30% lower than current retail pricing to learn more about DesignRx, or find a participating DesignRx pharmacy, please visit www.designrx.net
  • Offer not valid for prescriptions that may be covered under private or public insurance, or reimbursed under a federal or state healthcare program, including Medicare, Medicaid, or any other similar state healthcare program, including any state medical pharmaceutical assistance program. If you become insured by any private or government insurance, you must notify the program by calling 1-855-672-9264.


 
Medication Discounts:

Discounts will be applied to the following medications only:

  • Follistim AQ Cartridge (follitropin beta injection) - 300IU, 600IU, or 900IU
  • Ganirelix Acetate Injection
  • Pregnyl (chorionic gonadotropin for injection, USP)


 
Learn more about these fertility medications, including important safety information


Information on this page is available from its original source here. While we will strive to maintain the information on this page, this information is subject to change without notice.

Additional information