ReUnite Reassurance Details
We understand that many clinics and patients have concerns about fertility treatments in the midst of COVID-19 (coronavirus). Some patients may choose to delay IVF out of concerns they would need to cancel their cycle after starting stimulation medications. Unfortunately, there are no clear indicators for how long this pandemic may last and when it may be appropriate for those affected to resume treatments.
In an effort to keep our clinicians, staff, and patients safe and to help alleviate the financial concerns of some patients, we have created ReUnite Reassurance. If a patient undergoing IVF is quarantined due to COVID-19 requiring a cycle cancelation, ReUnite Rx will replace the patient’s Follistim, Ganirelix, and Pregnyl at no additional cost.
ReUnite Reassurance Program Requirements
ReUnite Reassurance will cover patients who require quarantine mid-cycle. Medical records and attestation from physician with reason for cancellation will be required. For patients in this circumstance, ReUnite needs to be notified the same day the stimulation is canceled.
ReUnite Rx Reassurance Form
Please complete the form and submit it to [email protected]. We will be in touch shortly thereafter.
Terms and Conditions for ReUnite Reassurance
- Patient must be diagnosed with COVID-19 with a positive lab result. Documentation of this lab result with dates consistent with IVF stimulation dates will need to be provided, or physician attestation of quarantine secondary to COVID-19.
- Patient will also need medical records from the fertility clinic indicating that their IVF cycle was canceled during controlled ovarian hyperstimulation.
- Patients will need to provide documentation that they were on Follistim AQ during their canceled IVF cycle. If the patient was not on Follistim, they are not eligible for ReUnite Reassurance.
- Replacement medication will be for medications that were used up until the cancellation date. Medications eligible for replacement are the following Merck & Co. products: Follistim AQ, Ganirelix Acetate, and Pregnyl.
- Medication replacement is only available through a participating ReUnite Rx network pharmacy. Original and replacement medications are for cash pay patients only. Patients with a fertility benefit will need to go through their fertility benefit program and are not eligible for ReUnite Reassurance.
- Medical records and application will need to be coordinated with ReUnite Rx. Please email [email protected] if you have a patient who is eligible for ReUnite Reassurance. We will coordinate with your clinic and the patient at that time to obtain appropriate documentation and fulfillment of replacement medications.
- ReUnite Rx reserves the rights in its sole discretion to approve, deny, or cancel ReUnite Reassurance program at any time.
- The purpose of ReUnite Reassurance is to provide as much assistance as possible during this crisis. The budget for the program is finite. The priority is to first use the program to take care of those who have had a cycle cancel due to a personal diagnosis with COVID 19, followed by those who have been quarantined due to known exposure. ReUnite acknowledges that States are enacting “Shelter in Place” policies which are, in certain geographic areas, resulting in active cycle cancellations. If the Shelter in Place mandates result in application volumes which prevent ReUnite from helping those who have been diagnosed or exposed, Reunite may adjust the approval criteria.
Additional Program terms, conditions, and eligibility criteria:
1) This offer is valid only for eligible patients and is good for use only when presented with a valid prescription for Follistim AQ Cartridge (follitropin beta injection), Ganirelix Acetate Injection, and/or Pregnyl (chorionic gonadotropin for injection, USP) at the time the prescription is filled by the pharmacist and dispensed to the patient. 2) This offer is only valid at participating ReUnite Rx network pharmacies. Visit www.reuniterx.com to see a list of our participating pharmacies. 3) This program is valid only for cash-paying patients. This offer is not valid for use by patients eligible or enrolled in Medicare, Medicaid, other federal or state programs, or private insurance plans that cover eligible medications. Patients who have insurance coverage for eligible medications or participate in federal or state programs are required to notify ReUnite Rx immediately. 4) ReUnite Rx discounts and rebates are not available in combination with any other rebate or discount offering. 5) ReUnite Rx discounts can only be applied to prescriptions filled after the qualification date. ReUnite Rx will not consider any discounts if the applicant has already purchased eligible medications. 6) Limitations for use and quantity of eligible medications are at the sole discretion of ReUnite Rx. 7) Minimum age to qualify is 18 years old. 8) Void if prohibited by law, taxed, or restricted. 9) This card has no cash value. This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. 10) By redeeming and/or using ReUnite Rx, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer. 11) ReUnite Rx is not insurance.