IZERVAY My Way -- Astellas Patient Assistance Program
Run by Astellas Pharma US, Inc.
IZERVAY My Way -- Astellas Patient Assistance Program, run by Astellas Pharma US, Inc., provides the medication at no cost if you qualify. One eligibility path: "You're uninsured, or you're insured but IZERVAY isn't covered even after appeals."
At a glance
- Run by
- Astellas Pharma US, Inc.
- Status
- Verified
- Last verified
- 08/18/26
- Medicare
- Has a Medicare eligibility path.
- Confirmed medications
- 1
- Coverage unconfirmed
- 0
Income limits and eligibility paths
Review each published path and its conditions. A path may apply only to certain medications or insurance coverage.
You're uninsured, or you're insured but IZERVAY isn't covered even after appeals
Gross annual household income cap disclosed directly in the primary-source PDF T&Cs, flat regardless of household size -- not FPL-based, unlike every LEO program. Most precise, most citable eligibility figure across the entire reopen pass.
Income basis
Published household amounts
Confirm the table’s geographic applicability and larger-household rules with the program.
You have Medicare Part B and it covers IZERVAY, but you can't afford the cost-sharing
Same household income cap as the uninsured track.
Income basis
Published household amounts
Confirm the table’s geographic applicability and larger-household rules with the program.
Insurance and other requirements
Each path has its own conditions. Read the complete requirements and confirm which path applies to you.
-
Path 1
You're uninsured, or you're insured but IZERVAY isn't covered even after appeals
Insurance category: no-insurance
- ·Gross annual household income cap disclosed directly in the primary-source PDF T&Cs, flat regardless of household size -- not FPL-based, unlike every LEO program. Most precise, most citable eligibility figure across the entire reopen pass.
- ·Prescribed by a licensed eye-care professional who certifies medical appropriateness.
- ·Resident of the 50 states, DC, or Puerto Rico, 18+.
- ·No billing of any party for free product; free-product value cannot count toward insurance out-of-pocket accumulator calculations.
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Path 2
You have Medicare Part B and it covers IZERVAY, but you can't afford the cost-sharing
Insurance category: medicare
- ·Same household income cap as the uninsured track.
- ·Affordability of cost-sharing determined by the program administrator.
- ·The only one of the 7 Astellas brands with an explicit Medicare-inclusive eligibility track for the PAP itself (not just a referral-to-call) -- genuinely Medicare-covered-but-still-assisted, structurally different from every other program in this reopen.
- ·Federal-program beneficiaries who qualify are enrolled for the entire calendar year and are not subject to the same mid-period reassessment language as uninsured/commercial patients -- a notable asymmetry in the source document.
What this program covers
1 confirmed covered, 0 documented exclusions and 0 unconfirmed associations. Check the category before relying on a medication link.
Covered medications
- IZERVAY Covered · 08/19/26
Confirmed covered associations. The program’s eligibility rules still apply.
Not on this program's current list
- No medications are documented in this category.
These exclusions refer to this program only. They do not prove that all other help is unavailable.
Coverage unconfirmed
- No medications are documented in this category.
Our records link these medications to this program, but we do not have enough evidence to confirm coverage. Contact the program before relying on this association.
How to apply
Continue to the official program website ↗
Use the program’s official application. Required documents, approval periods and renewal rules vary.
Keep your approval notice. It explains when assistance ends and what to do if renewal is required.
-
1
Check the official application
Confirm medication coverage and the eligibility path that fits your situation.
-
2
Gather the required documents
Use the income and insurance documents requested by the current form.
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3
Coordinate with your prescriber
Ask whether clinical information, a prescription or a signature is required.
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4
Submit and follow up
Confirm receipt and ask about the decision, approval period and renewal rules.
If this is more than you want to take on
Help with the application paperwork
You can follow the official application instructions yourself. If you choose paid help, ask which documents and follow-up tasks the fee includes.
Compare current pricing, cancellation terms and available reviews. Paying for paperwork does not establish eligibility or guarantee approval.
- Ask which forms the service prepares and submits
- Ask how the service works with your prescriber
- Check whether renewal assistance is included
Paid paperwork help is optional. Confirm the official program’s requirements first.
What changed
No rule changes recorded since we began tracking this program on 08/18/26.
Documents we track
Program document
Available on the program’s official website, last checked 08/18/26. Confirm current requirements at: https://www.izervay.com/pdfs/patient-assistance-program-terms-and-conditions.pdf.
This link points to the program’s own document. Check the record’s verification status and confirm current terms.
What changed on this record
IZERVAY My Way -- Astellas Patient Assistance Program requirements read and verified; tracking began.