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Verified Source checked 08/18/26

HYALGAN Patient Assistance Program

Run by Fidia Pharma USA Inc.

HYALGAN Patient Assistance Program, run by Fidia Pharma USA Inc., provides the medication at no cost if you qualify. One eligibility path: "You have no prescription drug insurance of any kind."

At a glance

Run by
Fidia Pharma USA Inc.
Status
Verified
Last verified
08/18/26
Medicare
No confirmed Medicare eligibility path for this program.
Confirmed medications
1
Coverage unconfirmed
0

Phone 1-866-749-2542

Income limits and eligibility paths

Review each published path and its conditions. A path may apply only to certain medications or insurance coverage.

Household size Annual income limit
1 $39,900
2 $54,100
3 $68,300
4 $82,500
5 $96,700

You have no prescription drug insurance of any kind

'They must have an annual income at or below 250% of the Federal Poverty Line.' CURRENCY RISK: the operative poverty table linked on the page is titled '2021 Poverty Guidelines' and the linked asset is 2021-vintage, so the manufacturer's own dollar figures are stale as of this 2026 read. The 250% multiple is recorded as stated; the dollar cascade should be computed against current guidelines, not the page's table.

Income basis

250% of the federal poverty level

Calculated from the 2026 federal poverty guidelines for the 48 contiguous states and DC. These figures do not apply to Alaska or Hawaii. Confirm regional and larger-household amounts 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 have no prescription drug insurance of any kind

    Insurance category: no-insurance

    • ·'They must have an annual income at or below 250% of the Federal Poverty Line.' CURRENCY RISK: the operative poverty table linked on the page is titled '2021 Poverty Guidelines' and the linked asset is 2021-vintage, so the manufacturer's own dollar figures are stale as of this 2026 read. The 250% multiple is recorded as stated; the dollar cascade should be computed against current guidelines, not the page's table.
    • ·Must not have any public or private prescription drug insurance.
    • ·Typical turnaround for a Reimbursement or PAP application is less than 48 hours.
    • ·Approved product ships via FedEx 2-day to the physician's office.

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

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. 1

    Check the official application

    Confirm medication coverage and the eligibility path that fits your situation.

  2. 2

    Gather the required documents

    Use the income and insurance documents requested by the current form.

  3. 3

    Coordinate with your prescriber

    Ask whether clinical information, a prescription or a signature is required.

  4. 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
Compare services that help you apply

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://hcp.hyalgan.com/hcp/reimbursement/.

This link points to the program’s own document. Check the record’s verification status and confirm current terms.

Record history

What changed on this record

  1. HYALGAN Patient Assistance Program requirements read and verified; tracking began.