(letermovir)  240 mg and 480 mg tablets

This private and confidential program provides product free of charge to eligible individuals, primarily the uninsured who, without our assistance, could not afford needed Merck medicines. Individuals who don’t meet the insurance criteria may still qualify for this program if they attest that they have special circumstances of financial and medical hardship, and their income meets the program criteria. A single application may provide for up to 1 year of product free of charge to eligible individuals and an individual may reapply as many times as needed.


Who May Qualify

You may qualify for patient assistance* if you meet all 3 of the following conditions:

  1. You are a US resident and have a prescription for a Merck product from a health care provider licensed in the United States.


  2. You do not have insurance or other coverage for your prescription medicine.


  3. You cannot afford to pay for your medicine.You may qualify for the patient assistance program if you have a household income of $75,300 or less for individuals, $102,200 or less for couples, or $156,000 or less for a family of 4.

* Offered through the Merck Patient Assistance Program, Inc.

You do not have to be a US citizen. Legal residents of the United States, including US Territories, are also eligible.

For income limits in Alaska and Hawaii, please call 1-800-727-5400.

How to Get Started

To apply for the Merck Patient Assistance Program for PREVYMIS™, you must complete an Enrollment Form for the Merck Access Program. The Merck Access Program provides support to help answer questions related to insurance coverage and reimbursement.

You and your health care provider can call the Merck Access Program at 855-404-5278 to request an enrollment form. The Merck Access Program Representatives are available 8 AM to 8 PM ET, Monday through Friday, to answer questions about the program.

Check Your Eligibility

Please answer these short questions to see if you may qualify. You must answer ALL questions on this page to be considered.
This information is not collected or retained.


Download Enrollment Form (Application)

To access the PREVYMIS™ enrollment form, click here.