Apply to Bristol Myers Squibb Patient Assistance Foundation
Free Bristol Myers Squibb medicines for people who are uninsured, or on Medicare with high drug costs, and meet income limits. Apply directly with the program; here is what it asks and what happens next.
Who can apply?
| Medicines | 1 person | 2 people | 3 people | 4 people |
|---|---|---|---|---|
| Eliquis, Orencia, Cobenfy | $47,880 | $64,920 | $81,960 | $99,000 |
| Nulojix | $75,012 | $101,708 | $128,404 | $155,100 |
| Zeposia | $103,740 | $140,660 | $177,580 | $214,500 |
Camzyos, Sotyktu, Abraxane, Augtyro, Empliciti and 16 moreIdhifa, Inrebic, Istodax, Krazati, Onureg, Opdivo, Opdivo Qvantig, Opdualag, Pomalyst, Reblozyl, Revlimid, Sprycel, Thalomid, Vidaza, Yervoy, Zenbexus | $150,024 | $203,416 | $256,808 | $310,200 |
Eliquis, Orencia, Cobenfy: $47,880 for 1, $64,920 for 2 (300% FPL). Cancer and most specialty medicines: $150,000 for 1 or 2, $177,580 for 3. Zeposia: $103,740 for 1 (650% FPL). Nulojix: $75,000 for 1. Medicare: must also have spent 3% of yearly household income on out-of-pocket prescriptions this calendar year.
Must have no insurance coverage for the prescribed medicine, or have Medicare and have spent at least 3% of yearly household income on out-of-pocket prescription costs in the same calendar year (infusion costs count). Some drugs are not available to Medicare patients (marked). Medicaid-eligible patients not enrolled must send a Medicaid denial. VA/TRICARE not named. Must be treated as an outpatient by a US-licensed prescriber. Percent-FPL values for high limits are converted from dollar amounts (rounded).
Then what?
Sign
- application (includes consent to soft credit check to estimate income)
Attach
- copies of front and back of insurance cards, if any
- proof of household income (federal tax return or other income documents) speeds processing
- Medicare: proof of out-of-pocket prescription spending equal to 3% of household income this year
- Extra Help (LIS) denial if under 150% FPL (site also says age 65+ on a self-administered product)
- Medicaid denial if Medicaid-eligible
Your prescriber
- completes, signs and dates the prescriber part of the application
Send
Questions: call Bristol Myers Squibb Patient Assistance Foundation at 1-800-736-0003. Up to 12 months depending on insurance; reapply after..
Free. BMSPAF "does not charge any application, participation, or delivery fees" and is not affiliated with third parties who charge a fee. EveryCard Rx isn't paid by the program and never sends anything for you. Form , rules checked 2026-11-06 from the program's own pages. Something out of date? Tell us.