Select which way you'd like to enroll in IncyteCARES for Jakafi:
Note that not all patients who have been prescribed Jakafi® (ruxolitinib) are eligible to enroll
in the program or to receive all services we provide.
To Enroll Through Your Healthcare Professional
Both you and your Healthcare Professional need to provide information.
Both you and your Healthcare Professional need to provide information.
Ask your Healthcare Professional to fill out a program enrollment form for you.
You will need to provide:
- The address for monthly delivery of your Jakafi
- Your insurance information
- Your financial information, including current household income (if you want to see if you qualify for the free drug program)
- Your Patient Authorization for the IncyteCARES for Jakafi program (This means you give permission for your Healthcare Professionals to share your personal medical information with us as part of the program.)
To provide this you can either:
- Sign the Patient Authorization section of the enrollment form,
- Let your Healthcare Professional submit the form without your signature, and an IncyteCARES for Jakafi representative will call you to obtain your authorization verbally or by mail
Your Healthcare Professional will provide:
- Your condition
- Your prescription for Jakafi
To provide this you can either:
- Sign the Patient Authorization section of the enrollment form,
- Let your Healthcare Professional submit the form without your signature, and an IncyteCARES for Jakafi representative will call you to obtain your authorization verbally or by mail
Your Healthcare Professional will submit your enrollment form.
You may receive a phone call from an IncyteCARES for Jakafi representative if any of your information is incomplete on the form. You can provide this verbally or by mail.
We’ll call to confirm your enrollment.
Once we validate the information you and your Healthcare Professional provide and confirm you’re eligible for IncyteCARES for Jakafi, we will immediately enroll you and let you know by phone that you’ve been enrolled. You can then take advantage of the services and support for which you’re eligible.
On our welcome call with you, an IncyteCARES for Jakafi representative can:
On our welcome call with you, an IncyteCARES for Jakafi representative can:
- Discuss your insurance coverage for Jakafi
- Identify financial assistance options that may help you
- Set up monthly deliveries of your Jakafi
- Review information about your medicine and more
Need Help?
Our IncyteCARES for Jakafi team is available Monday through Friday, 8 AM–8 PM ET
Call us at 1-855-452-5234
To Enroll by Calling IncyteCARES for Jakafi
Both you and your Healthcare Professional need to provide information to get you enrolled.
Both you and your Healthcare Professional need to provide information to get you enrolled.
Call IncyteCARES for Jakafi
Representatives are available to enroll you Monday through Friday, 8 AM–8 PM ET.
You will need to provide:
- The address for monthly delivery of your Jakafi
- Your insurance information
- Your financial information, including current household income (if you want to see if you qualify for the free drug program)
- Your verbal Patient Authorization for the IncyteCARES for Jakafi program (This means you give permission for your Healthcare Professionals to share your personal medical information with us as part of the program.)
If you prefer not to provide information over the phone, we can mail you an enrollment form to complete and return by mail.
If you prefer not to provide information over the phone, we can mail you an enrollment form to complete and return by mail.
We will contact your prescribing Healthcare Professional to complete your enrollment form.
Your Healthcare Professional will provide:
- Your condition
- Your prescription for Jakafi
We’ll call to confirm your enrollment.
Once we validate the information you and your Healthcare Professional provide and confirm you’re eligible for IncyteCARES for Jakafi, we will immediately enroll you and let you know by phone that you’ve been enrolled. You can then take advantage of the services and support for which you’re eligible.
On our welcome call with you, an IncyteCARES for Jakafi representative can:
On our welcome call with you, an IncyteCARES for Jakafi representative can:
- Discuss your insurance coverage for Jakafi
- Identify financial assistance options that may help you
- Set up monthly deliveries of your Jakafi
- Review information about your medicine and more
Need Help?
Our IncyteCARES for Jakafi team is available Monday through Friday, 8 AM–8 PM ET
Call us at 1-855-452-5234