{"id":25006,"date":"2024-02-09T02:41:09","date_gmt":"2024-02-09T02:41:09","guid":{"rendered":"https:\/\/ameripharmaspecialty.com\/?page_id=25006"},"modified":"2026-03-19T15:43:43","modified_gmt":"2026-03-19T22:43:43","slug":"mitomycin-copay-assistance","status":"publish","type":"page","link":"https:\/\/ameripharmaspecialty.com\/zh\/mitomycin-copay-assistance\/","title":{"rendered":"Mitomycin \u5171\u4ed8\u989d\u63f4\u52a9"},"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-837bc8b0490b3c0dcfffff794cf676a4\" 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\/vi\/\">Home<\/a><\/span><\/span><\/p>\t\t\t\t<h2 class=\"title\">Get Financial Relief Now<\/h2>\n\t\t\t\t<p class=\"text\">Apply for Mitomycin Copay Assistance<\/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\">Talk To A Specialist<\/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-c090cb6ce135afd7e0983f17d640f9b3\" 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<\/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-30-text-70-a9bdaa7b67b265d7de0bbc217abf7399\" 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\/pharmacist.jpg\">\n\t\t\t\t\t<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\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<h2>What is Mytomycin?<\/h2>\n<p>First identified by microbiologists in Japan in the 1950s,\u00a0<a href=\"https:\/\/ameripharmaspecialty.com\/cancer\/mitomycin-explained-uses-side-effects-dosage-and-cost\/\">mitomycin<\/a>\u00a0is an alkylating, anti-tumor antibiotic that belongs to the antineoplastics (or cytotoxic) group of medicines. It is one of the oldest chemotherapy drugs, having been used for decades, and is available under the trade name of Mutamycin and is also available as MTC or Mitomycin-C.<\/p>\n<p>This medication works by impeding the development of DNA, the cell\u2019s genetic material. This stops cancer cells from splitting into two new cells. Mitomycin can also impact normal cell growth; therefore, it is usually not the first treatment option. Mitomycin can cause serious side effects, and patients using this medication must be closely monitored.<\/p>\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=\"image-30-text-70-92994c86c49a81c8acbbca575e070c5b\" 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=\"mkdf-row-grid-section-wrapper\">\n<div class=\"mkdf-row-grid-section\">\n<div class=\"vc_row wpb_row vc_inner vc_row-fluid vc_custom_1646858311492\">\n<div class=\"padding_left_mobile wpb_column vc_column_container vc_col-sm-6\">\n<div class=\"vc_column-inner vc_custom_1648575521672\">\n<div class=\"wpb_wrapper\">\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h2>What is Mytomycin Used to Treat?<\/h2>\n<p>Mitomycin is used in chemotherapy to treat certain types of cancer, including peritoneum, lung, lip, oral cavity, pharynx, head and neck, colorectal, cervical, breast, bladder, and anal cancer. It is also used for treating mesotheliomas,\u00a0<a href=\"https:\/\/www.cancer.org.au\/cancer-information\/types-of-cancer\/adenocarcinoma\">adenocarcinoma<\/a>\u00a0of the pancreas or stomach, and low-grade upper tract urothelial cancer in adults. In addition, mitomycin has recently been found beneficial to use adjunctly in glaucoma surgeries.<\/p>\n<p>Because of the potential effects on healthy cells, the drug is generally recommended when cancer has spread throughout the body and is not responding to treatment from radiation, surgery, or other medications.<\/p>\n<\/div>\n<\/div>\n<div class=\"vc_empty_space\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\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-1bd31c4cbde41c6e83e85563236433a6\" 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-fc413a0bf62152dc8bdbd6f918a9f185\" 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\/05\/doctor-patient.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/05\/doctor-patient-sm.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/05\/doctor-patient.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>Mitomycin Dosing Information<\/h2>\n<blockquote><p>Mitomycin is administered by a trained medical professional in an outpatient chemotherapy unit or through a hospital stay. The drug may be used in tandem with radiotherapy or with additional cancer-treating drugs. Medical professionals who will assist with the administration of treatment include cancer doctors (oncologists), chemotherapy or specialist nurses, and specialist pharmacists.<\/p><\/blockquote>\n<p>Prior to receiving the treatment, a phlebotomist will draw a blood sample to ensure that blood cells are at an appropriate level for chemotherapy. Antiemetic drugs are generally administered prior to the start of treatment to prevent sickness. The drug will be administered through one of the following:<\/p>\n<ul>\n<li aria-level=\"1\">Cannula: A tube inserted in a vein in the hand or arm<\/li>\n<li aria-level=\"1\">Central line: A tube inserted into a vein under the skin of the chest<\/li>\n<li aria-level=\"1\">PICC line: A tube inserted into a vein in the arm<\/li>\n<li aria-level=\"1\">Implantable port: A disc implanted under the skin on the arm or chest, connected to a vein in the chest<\/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-52d81e7d392f86ecf2fcf836ad2c9dca\" style=\"\" class=\"copaySideEffectList\">\n\t<div class=\"container\">\n\t\t<h2 class=\"title\">Mitomycin Side Effects<\/h2>\n\t\t<div class=\"content  sideEffectList\" id=\"sideEffectList\">\n\t\t\t<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<p>While mitomycin may cause some side effects, it is important to remember that not everyone will experience any or all of the possible side effects, and there are numerous options to prevent or minimize them. The onset and duration of side effects are generally predictable, and they are nearly always reversible and cease once the treatment is finished. Side effects due to\u00a0 mitomycin largely depend on the quantity of the drug used and the process of dosing. An experienced medical professional will monitor the patient throughout the process.<\/p>\n<\/div>\n<\/div>\n<div class=\"vc_row wpb_row vc_inner vc_row-fluid\">\n<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n<div class=\"vc_column-inner\">\n<div class=\"wpb_wrapper\">\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h3>Allergic Reactions<\/h3>\n<p>Some individuals may have an allergy to this drug and experience one of the following reaction symptoms:<\/p>\n<ul>\n<li aria-level=\"1\">Shortness of breath<\/li>\n<li aria-level=\"1\">Dizziness<\/li>\n<li aria-level=\"1\">Headache<\/li>\n<li aria-level=\"1\">Itching<\/li>\n<li aria-level=\"1\">Flushing or feeling hot<\/li>\n<li aria-level=\"1\">Pain in the back, chest, or stomach<\/li>\n<li aria-level=\"1\">Rash<\/li>\n<li aria-level=\"1\">Shivering<\/li>\n<li aria-level=\"1\">Swelling of the mouth or face<\/li>\n<li aria-level=\"1\">Wheezing<\/li>\n<\/ul>\n<h3>Side Effects Reported by Over 30% of Patients<\/h3>\n<ul>\n<li aria-level=\"1\">Bleeding gums<\/li>\n<li aria-level=\"1\">Fatigue<\/li>\n<li aria-level=\"1\">Low blood counts (temporary decrease in both red and white blood cells and platelets)<\/li>\n<li aria-level=\"1\">Mouth sores<\/li>\n<li aria-level=\"1\">Nosebleeds<\/li>\n<li aria-level=\"1\">Poor appetite<\/li>\n<\/ul>\n<h3>Side Effects Reported by 10-29% of Patients<\/h3>\n<ul>\n<li aria-level=\"1\">Bladder inflammation (burning, cramping, pain, and frequency of urination)\u00a0\u2014\u00a0generally experienced with intravesical therapy<\/li>\n<li aria-level=\"1\">Blisters, dry skin, itching, or rash<\/li>\n<li aria-level=\"1\">Coughing or breathing difficulties<\/li>\n<li aria-level=\"1\">Diarrhea<\/li>\n<li aria-level=\"1\">Fever<\/li>\n<li aria-level=\"1\">Hair loss<\/li>\n<li aria-level=\"1\">Kidney changes<\/li>\n<li aria-level=\"1\">Mild vomiting and nausea<\/li>\n<li aria-level=\"1\">Redness or soreness on the palms and soles (also known as hand-foot syndrome)<\/li>\n<\/ul>\n<h3>Rare But Potentially Serious Complications<\/h3>\n<ul>\n<li aria-level=\"1\">Extravasation. When the medication leaks outside the vein, it can cause serious tissue damage.<\/li>\n<li aria-level=\"1\">Hemolytic-uremic syndrome (seen in fewer than 2% of patients). This condition can lead to damage to blood vessel walls, destruction of red blood cells, and potential kidney failure.<\/li>\n<li aria-level=\"1\">Lung conditions (including pneumonitis or pulmonary fibrosis). Usually, lung conditions occur more often in older patients or those with pre-existing lung problems.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-insurance-companies-65ddd51f760a6e39de6da05b6a9521d3\" 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-51be70a7bb321f2f99a7239ec1006be7\" 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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