How to Fill Out the Cosentyx Covered Until You’re Covered Enrollment Form

To enroll in the Cosentyx Covered Until You’re Covered bridge program, you and your prescriber fill out the Cosentyx Start Form and submit it to Novartis by fax, online portal, or phone. Once approved, the program supplies Cosentyx at no cost for up to two years or until your commercial insurance approves coverage, whichever comes first.¹

Check That You Qualify Before You Fill Anything Out

Three things have to be true: you have commercial (private) insurance, you have a valid Cosentyx prescription for an FDA-approved indication, and your insurer has denied a prior authorization, predetermination, or medical exception request.¹ A slow decision is not the same as a denial; the program’s terms require an actual denial on file.

Cosentyx is approved for moderate to severe plaque psoriasis (ages six and up), active psoriatic arthritis (ages two and up), ankylosing spondylitis, non-radiographic axial spondyloarthritis, enthesitis-related arthritis (ages four and up), and moderate to severe hidradenitis suppurativa in adults.² You also must live in the United States or Puerto Rico.³

One hard boundary: patients covered by Medicare, Medicaid, TRICARE, or VA plans are not eligible for this program. And only the patient, a legal guardian, or a caregiver can enroll. Health plans, specialty pharmacies, and pharmacy benefit managers are prohibited from enrolling you.⁴

Where to Get the Start Form

The enrollment document is called the Cosentyx Start Form. You can download the PDF from the Novartis HCP site, or ask your dermatologist’s or rheumatologist’s office for a copy. Most practices that prescribe Cosentyx keep the form on hand.⁵ The form has distinct patient and prescriber sections, so plan to complete it during an office visit or in close coordination with your doctor’s staff.

What You Fill In

Personal Information

The top of the form asks for your full legal name, date of birth, home address, phone number, and email. Match the name on your insurance card exactly. A mismatch between “William” on the ID and “Bill” on the form is enough to slow things down.

Insurance Information

This section causes the most trouble. Pull out your insurance card, front and back, and enter:⁵

Medical plan name, policy phone number, Member ID, and Group Number.
If your pharmacy benefits are managed separately, the Rx Group Number, PCN, and BIN. These codes are usually printed on the back of the card.

A wrong BIN or PCN is one of the fastest ways to get an administrative rejection. If you cannot find the numbers, call the member services line on the back of your card and ask a representative to read them to you.

Authorization and Signature

The authorization section lets Novartis and its partners share your health information with your insurer and the specialty pharmacy that will ship the medication, and it is written to comply with HIPAA.⁵ Without a signed authorization, the program cannot coordinate your benefits or arrange shipping. Sign and date it by hand, using the same name that appears on your insurance records. There is also an optional field to name a caregiver who can receive information about your enrollment.

What Your Doctor Fills In

Your prescriber completes the clinical section. It includes:

The ICD-10 diagnosis code for your condition. The form provides checkboxes for each approved indication, for example L40.0 for plaque psoriasis or M45.0 for ankylosing spondylitis.⁵
The prescriber’s National Provider Identifier (NPI) and Tax Identification Number (TIN).
A handwritten prescriber signature. Stamped signatures and unverified electronic signatures are typically not accepted for high-cost specialty programs like this one.

Missing clinical details are a common cause of delay. Novartis will contact the prescriber to collect anything left blank, but that adds days. If the office staff is unfamiliar with the form, point them to the HCP section of the Novartis support site, which walks providers through each field.⁶

How to Submit the Form

There are three submission options:

Fax the signed form to 844-666-1366. This is the most common route for doctor’s offices, and the fax confirmation gives you proof of submission.⁶
Submit electronically. Providers can file through the CoverMyMeds portal at covermymeds.health, and patients can enroll directly through the Cosentyx Connect portal. Novartis says online sign-up takes about two to three minutes.⁶
Call 844-COSENTYX (844-267-3689), Monday through Friday, 8:00 AM to 8:00 PM Eastern, excluding holidays.⁴

Mailing a paper form is technically possible but adds days or weeks. If you need medication soon, use fax or the online portal.

What Happens After You Submit

Novartis specialists review your clinical and insurance information to confirm you meet the bridge program criteria. The manufacturer does not publish a specific processing timeline, so plan on at least several business days. If anything is missing, the support team will contact you or your prescriber.

Once approved, you will receive a notification and a welcome call from a designated specialty pharmacy, which ships the medication to your home or to your doctor’s office depending on your preference and your prescription. The pharmacy also sets up the refill schedule so there are no treatment gaps while your appeal moves forward. To check status at any point, call Novartis Patient Support at 844-267-3689.¹

Keep Your Spot: The 90-Day Appeal Rule

The requirement most people miss: you must file an appeal of your insurance denial within the first 90 days of enrollment to stay in the bridge program.⁷ The program is designed to bridge you to coverage, not to replace it, so Novartis expects you to actively pursue approval. Many prescribers’ offices file the appeal for you as part of the normal prior authorization workflow, but confirm it has gone out.

Novartis may also ask you to re-verify your insurance at any point. You are responsible for telling Novartis if your prescription drug coverage changes, including a job change or new eligibility for Medicare or Medicaid. Gaining government coverage ends your eligibility.¹

What Comes After the Bridge

If your insurer approves coverage, the bridge program ends and you move to standard pharmacy benefits, where copays and coinsurance can still be substantial. The separate Cosentyx Co-Pay Plus program can reduce commercially insured patients’ cost to as little as $0 per fill, up to an annual maximum benefit of $16,000.⁸ Sign up through the Cosentyx Connect portal at support.cosentyx.com, by calling 844-267-3689, or through your doctor’s office.¹ Co-Pay Plus is also closed to patients on Medicare, Medicaid, TRICARE, or VA plans.

If the two-year bridge window closes and you still have no coverage, ask your prescriber about the Novartis Patient Assistance Foundation (NPAF), which provides Cosentyx at no cost to patients with limited or no prescription drug coverage who meet income guidelines. Decisions are generally issued within about four weeks, so start the conversation well before your bridge enrollment ends to avoid a treatment gap.⁹

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