ReUnite Reassurance

Assistance for Patients during COVID-19

The ReUnite Reassurance program offers financial relief to fertility patients whose IVF cycles are canceled due to COVID-19. If quarantine for COVID-19 resulted in the cancellation of your cycle, ReUnite Reassurance will replace any used Follistim AQ, Ganirelix Acetate, and Pregnyl at no cost to you.

Eligible Medications

• Follistim AQ Cartridge (follitropin beta injection) – Limit of 2700 IU
• Ganirelix Acetate Injection (brand name) – Limit of 5 syringes
• Pregnyl (chorionic gonadotropin for injection, USP) – Limit of 1 vial

Program Requirements

• IVF cycle cancellation due to quarantine for COVID-19 before December 30, 2020*
• Program application must be received the same day the cycle is canceled
• Patient was taking Follistim AQ during the canceled cycle
• Cash-pay patient (100% uninsured)
• Medications were purchased at MDR Fertility Pharmacy

Application Instructions

1. Download the ReUnite Reassurance Program Form.

2. Ask your physician to complete the program form and provide medical records documenting a canceled IVF cycle due to quarantine for COVID-19.

3. Email [email protected] with the completed ReUnite Reassurance Program Form and medical records documenting a canceled cycle due to COVID-19.

4. You will receive an email notification from ReUnite within 48 hours regarding your application status.

ReUnite Reassurance Program Form

For more information about this program, call 1-800-515-3784 or email [email protected].

Terms and Conditions

Medical records are required from the fertility clinic indicating that the IVF cycle was canceled during controlled ovarian hyperstimulation due to quarantine for COVID-19. Documentation that the patient was taking Follistim AQ during the canceled IVF cycle is required. Patients not taking Follistim are ineligible for the ReUnite Reassurance Program. Medications will be replaced based on the quantity used up until the cancellation date. Medications eligible for replacement are the following Merck & Co. products: Follistim AQ, Ganirelix Acetate, and Pregnyl. Medical records and application will need to be reviewed and approved by ReUnite Rx. ReUnite Reassurance will be available to patients whose IVF cycles were canceled due to quarantine for COVID-19. ReUnite Rx reserves the rights in its sole discretion to approve, deny, or cancel ReUnite Reassurance program applications.

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