{"id":28252,"date":"2026-04-30T15:32:29","date_gmt":"2026-04-30T22:32:29","guid":{"rendered":"https:\/\/ameripharmaspecialty.com\/?page_id=28252"},"modified":"2026-06-16T10:11:05","modified_gmt":"2026-06-16T17:11:05","slug":"ho-tro-dong-thanh-toan-glassia","status":"publish","type":"page","link":"https:\/\/ameripharmaspecialty.com\/vi\/glassia-copay-assistance\/","title":{"rendered":"H\u1ed7 tr\u1ee3 \u0111\u1ed3ng thanh to\u00e1n GLASSIA"},"content":{"rendered":"<style>\n\t@media screen and (min-width: 1023px) {\n\t\t.copayHeroBanner-image {\n\t\t\tposition: absolute;\n\t\t\ttop: 0;\n\t\t\tleft: 0;\n\t\t\twidth: 100%;\n\t\t\theight: 100%;\n\t\t\tz-index: -1;\n\t\t}\n\n\t\t.copayHeroBanner-image img {\n\t\t\tobject-fit: cover;\n\t\t\theight: 100%;\n\t\t\twidth: 100%;\n\t\t}\n\t}\n<\/style>\n\n<div  id=\"copay-hero-banner-4e86c214d3a3d5aefbd168087dedd6aa\" style=\"\" class=\"copayHeroBanner\">\n\t<div class=\"container\">\n\t\t<div class=\"banner-wrap \">\n\t\t\t<div class=\"content\">\n\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/ameripharmaspecialty.com\/\">Home<\/a><\/span><\/span><\/p>\t\t\t\t<h2 class=\"title\">Apply for GLASSIA Copay Assistance<\/h2>\n\t\t\t\t<p class=\"text\">Get Financial Relief Now<\/p>\n\n\t\t\t\t<div class=\"list\">\n\t\t\t\t\t<ul>\n<li>Free service matches you with top copay assistance programs<\/li>\n<li>Specialists assist you throughout the application process<\/li>\n<li>Get automated updates on your funding status<\/li>\n<li>Over $55 million secured for our patients to date<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t\t\t<div class=\"button-wrap\">\n\t\t\t\t\t\t<a class=\"button\" href=\"#form\" target=\"_self\">Check My Eligibility<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<picture class=\"copayHeroBanner-image\">\n\t\t\t\t<source media=\"(min-width:1023px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/copay-banner-desktop-scaled.jpeg\">\n\t\t<img decoding=\"async\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/copay-banner-mbile-no-gradient.jpeg\" alt=\"\">\n\t<\/picture>\n<\/div>\n\n\n<div  id=\"copay-how-it-works-bee75ec11ceaafa31d08ca113a736d2d\" style=\"\" class=\"copayAssistanceWork\">\n\t<div class=\"container\">\n\t\t<div class=\"copayAssistanceWork-wrapper\">\n\t\t\t<div class=\"top-section\">\n\t\t\t\t<h2 class=\"title\">How Assistance Works<\/h2>\n\t\t\t\t<p class=\"subtext\">Streamlining our patient\u2019s specialty pharmacy experience with unmatched full-service convenience<\/p>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<ul class=\"bottom-section\">\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step1.png\" class=\"attachment-full size-full\" alt=\"Coverage Verification Code\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">1. Check Your Coverage\/Benefits Verification<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Our team of expert billers finds the best avenues of coverage that minimize out-of-pocket costs.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step2.png\" class=\"attachment-full size-full\" alt=\"Transfer Prescription to AmeriPharma - Image\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">2. Transfer Prescription to AmeriPharma\u00ae<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">We process your prescription by working with your previous pharmacy or prescriber, making the transition quick and easy.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step3.png\" class=\"attachment-full size-full\" alt=\"Icon - Eligard copay assistance process\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">3. Prior Authorization<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Our team of specialists obtains approval from your insurance companies within 24 to 72 hours.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step4.png\" class=\"attachment-full size-full\" alt=\"Eligard Copay Financial Assistance Icon\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">4. Copay Assistance &#038; Financial Aid<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">We secure financial aid and decrease copays, out-of-pocket expenses, and high deductibles. To date, AmeriPharma\u00ae Specialty Care has secured $55 million in financial assistance for our patients.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step5.png\" class=\"attachment-full size-full\" alt=\"Nursing Care Logo\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">5. Nursing Care Coordination If Needed<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">AmeriPharma\u00ae puts your schedule and home environment first when scheduling and coordinating one of our specialized nurses for your in-home infusions.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step6.png\" class=\"attachment-full size-full\" alt=\"Delivery Coordination - Image\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">6. Delivery Coordination<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Medications are always delivered in strict compliance with the specific requirements for shipping. Next-day and overnight cold-chain deliveries are coordinated around your schedule.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"image-with-text-4a4411f71d40dfd4a2bf4de88a983245\" style=\"\" class=\"small-photo ct_image_with_text\">\n        <div class=\"container\">\n        <div class=\"block-spacing block-wrap image_with_text \">\n                            <div class=\"image_with_text_content\">\n                    <h2>Overview of GLASSIA<\/h2>\n<p>If you\u2019ve been diagnosed with emphysema (a lung disease) or are experiencing symptoms similar to emphysema due to\u00a0<a href=\"http:\/\/my.clevelandclinic.org\/health\/diseases\/21175-alpha-1-antitrypsin-deficiency\" target=\"_blank\" rel=\"noreferrer noopener\">alpha-1 antitrypsin deficiency<\/a>\u00a0(AATD), your healthcare provider may prescribe a medication called GLASSIA.<\/p>\n<p>GLASSIA, also known by its generic name, alpha-1 proteinase inhibitor (Alpha 1-PI), was approved by the\u00a0<a href=\"https:\/\/www.fda.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">FDA<\/a>\u00a0on July 1, 2010, for AATD. This medication replaces the missing Alpha 1-PI in adults with AATD and helps prevent further lung damage.<\/p>\n<p>GLASSIA infusions are FDA-approved for chronic augmentation and maintenance therapy in adults who have emphysema due to severe hereditary deficiency of alpha-1 proteinase inhibitors.<\/p>\n<p><strong>Note:<\/strong>\u00a0Alpha-1 proteinase inhibitor (Alpha 1-PI) and alpha-1 antitrypsin (AAT) are both terms that refer to the same protein.<\/p>\n                <\/div>\n                                        <div class=\"image_with_text_media\">\n                    <picture>\n                                                <source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/pharmacist.jpg\">\n                        <img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_mobile.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/pharmacist.jpg\" style=\"width:auto;\">\n                    <\/picture>\n                <\/div>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div  id=\"image-30-text-70-e3d5ad632a668de54409e7ac7cb45e7f\" style=\"\" class=\"img30text70 light_gray\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap left\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_1.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block-image-2.jpeg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_1.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h2 id=\"h-composition-and-mechanism-of-action\" class=\"wp-block-heading\">Composition and Mechanism of Action<\/h2>\n<p>GLASSIA is made from human plasma (the liquid part of the blood), which contains alpha-1 proteinase inhibitor protein.<\/p>\n<p>Normally, alpha 1-PI or ATT protein protects the lungs by stopping the activity of an enzyme (a protein) called neutrophil elastase, which kills bacteria in the lungs.<\/p>\n<p>However, in people with AAT deficiency, elastase doesn\u2019t stop working and eventually damages the lungs. This typically leads to emphysema, which causes symptoms like shortness of breath, wheezing, and a chronic cough.<\/p>\n<h3 id=\"h-mechanism-of-action\" class=\"wp-block-heading\"><span id=\"Mechanism_of_Action\" class=\"ez-toc-section\"><\/span>Mechanism of Action<\/h3>\n<p>GLASSIA treatments work by raising the alpha-1 PI levels in the bloodstream. This helps lower inflammation and prevent further damage to lung tissue, thereby slowing the progression of lung disease.<\/p>\n<p><strong>Note:<\/strong>\u00a0GLASSIA is not a cure for AAT deficiency; it only helps to manage this\u00a0<a href=\"https:\/\/ameripharmaspecialty.com\/conditions-treatments\/\">complex condition<\/a>\u00a0and slow down or prevent further lung damage.<\/p>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-assistance-94e24b69d36fbbe8f1bd49d76fbb552e\" style=\"\" class=\"copayAssistance\">\n\t<div class=\"container\">\n\t\t<div class=\"copayAssistanceWrap\">\n\t\t\t<h2 class=\"title\">Copay and Financial Assistance<\/h2>\n\t\t\t<p class=\"text\">AmeriPharma\u00ae Specialty Pharmacy alleviates financial burdens for patients and their families<\/p>\n\t\t\t\t\t\t\t<ul class=\"list\">\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"75\" height=\"75\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon1-1.png\" class=\"attachment-full size-full\" alt=\"Advanced software Icon\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">Advanced software locates funding sources to match you with top-dollar foundation programs<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"67\" height=\"66\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon2.png\" class=\"attachment-full size-full\" alt=\"Copay and Financial Assistance\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">One of our copay assistance specialists will assist with the application process<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"75\" height=\"75\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon3.png\" class=\"attachment-full size-full\" alt=\"Funding Icon\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">Automatic updates will be sent to you and your physician on the status of the funding<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div  id=\"image-30-text-70-cc5bf2dd2feb058e37d0644b036e1abd\" style=\"\" class=\"img30text70 white\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap right\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/Mask-Group-45-1.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/Mask-Group-45-2.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/Mask-Group-45-1.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h2 id=\"h-contraindications-and-warnings\" class=\"wp-block-heading\">Contraindications and Warnings<\/h2>\n<p>GLASSIA is contraindicated in patients who have:<\/p>\n<ul class=\"wp-block-list\">\n<li>Active lung infections<\/li>\n<li>A history of severe allergic reactions to alpha 1-PI products<\/li>\n<li><a href=\"https:\/\/ameripharmaspecialty.com\/other-health-conditions\/iga-deficiency\/\">Immunoglobulin A (IgA) deficiency<\/a>\u00a0with antibodies against IgA<\/li>\n<\/ul>\n<p>Furthermore, you may get an infection from GLASSIA. Although this medication is made from human blood and undergoes a rigorous testing and screening process, there is still a chance that it might contain infectious agents such as:<\/p>\n<ul class=\"wp-block-list\">\n<li>Viruses<\/li>\n<li>The variant\u00a0<a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/creutzfeldt-jakob-disease\/symptoms-causes\/syc-20371226\" target=\"_blank\" rel=\"noreferrer noopener\">Creutzfeldt-Jakob disease<\/a>\u00a0(vCJD)<\/li>\n<li>The Creutzfeldt-Jakob disease (CJD) agent<\/li>\n<\/ul>\n<h2 id=\"h-precautionary-measures\" class=\"wp-block-heading\"><span id=\"Precautionary_Measures\" class=\"ez-toc-section\"><\/span>Precautionary Measures<\/h2>\n<p>Before opting for GLASSIA, tell your healthcare provider if you are\/have:<\/p>\n<ul class=\"wp-block-list\">\n<li>Pregnant or plan to become pregnant because it is not known whether GLASSIA treatments can cause harm to an unborn baby.<\/li>\n<li>Breastfeeding or plan to breastfeed, since there is no information available on how GLASSIA infusions may affect breastfed infants or milk production.<\/li>\n<li>Taking any over-the-counter medications, supplements, or herbal products.<\/li>\n<li>Any health problem like liver disease, chronic obstructive pulmonary disease (<a href=\"https:\/\/www.drugs.com\/cg\/copd-chronic-obstructive-pulmonary-disease.html\" target=\"_blank\" rel=\"noreferrer noopener\">COPD<\/a>), or other breathing problems.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-side-effect-list-a2696cd0dd1aadcee63350d0c22ccfc5\" style=\"\" class=\"copaySideEffectList\">\n\t<div class=\"container\">\n\t\t<h2 class=\"title\">GLASSIA Side Effects<\/h2>\n\t\t<div class=\"content  sideEffectList\" id=\"sideEffectList\">\n\t\t\t<h5><strong>Common side effects include:<\/strong><\/h5>\n<ul class=\"wp-block-list\">\n<li>Cough<\/li>\n<li>Fatigue<\/li>\n<li>Nausea<\/li>\n<li>Dizziness<\/li>\n<li>Sinus infection<\/li>\n<li>Chest discomfort<\/li>\n<li>Shortness of breath<\/li>\n<li>Increased liver enzymes<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong style=\"font-size: 2.2rem;\">Serious side effects include:<\/strong><\/p>\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<ul>\n<li>Worsening or flare-up of chronic obstructive pulmonary disease (COPD)<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-insurance-companies-0e3d9c49e43b16f870e53513b6934b0f\" style=\"\" class=\"copayInsuranceCompanies\">\n\t<div class=\"container\">\n\t\t<h3 class=\"title\">Insurances Accepted<\/h3>\n\t\t<p class=\"text\">We accept Medicare, multi-state Medicaid, Medi-Cal, Blue Shield, and most private insurances. Call us to find out more about your coverage.<\/p>\n\t\t\t\t\t<ul class=\"list\">\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"218\" height=\"34\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo.png\" class=\"attachment-full size-full\" alt=\"Medicare logo displayed in the website footer.\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo.png 218w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo-86x13.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo-167x26.png 167w\" sizes=\"auto, (max-width: 218px) 100vw, 218px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"270\" height=\"58\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo.png\" class=\"attachment-full size-full\" alt=\"Medicaid logo\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo.png 270w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo-86x18.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo-167x36.png 167w\" sizes=\"auto, (max-width: 270px) 100vw, 270px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"104\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137.png\" class=\"attachment-full size-full\" alt=\"Blue Cross Blue Shield Logo\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137.png 200w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137-86x45.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137-167x87.png 167w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<\/ul>\n\t\t\t<\/div>\n<\/div>\n\n\n\n<div id=\"form\">\n\t<div  id=\"copay-form-bbfd873cbdd4ff615defc66502c089e2\" style=\"\" class=\"copayForm\">\n\t\t<div class=\"container\">\n\t\t\t<div class=\"copayForm-wrapper\">\n\t\t\t\t<div class=\"content\">\n\n\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"title\">Get Started in Minutes<\/h2>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text\">Fill out your information and one of our specialists will call you ASAP.<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"question\">How Much Can You Save?<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"answer\">Complete this form to save up to 100%!<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<!--<a class=\"contact-button\" href=\"tel:8777780318\">(877) 778-0318<\/a>-->\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"form\">\n\t\t\t\t\t<div id=\"iframe-container\"><\/div>\n\t\t\t\t\t<script>     \n                        window.addEventListener('DOMContentLoaded', () => {\n                            function buildForm(posthogID) {\n                                let formId = 'Lac86iCjiIyfdFLJylVF';\n                                let formHeight = '400px';\n                                function getURLParameter(e){return decodeURIComponent((RegExp(e+\"=(.+?)(&|$)\").exec(location.search)||[,null])[1])}   \n                                let utmParams = ['utm_source','utm_medium','utm_campaign','utm_campaignid','utm_adgroup','utm_term','utm_keyword','keyword','device','match','loc','utm_network','gclid','extensionid', 'sitelink']; 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