Help appealing denials for this long-acting RSV antibody for infants.

Appeal Your Enflonsia Denial

Get access to this RSV prevention treatment for your infant.

Understanding Your Enflonsia (clesrovimab) Denial

Enflonsia (clesrovimab) is a long-acting monoclonal antibody for preventing RSV lower respiratory tract disease in neonates and infants. RSV is a leading cause of infant hospitalization. While similar to other RSV preventives, insurance may have specific criteria or prefer alternatives.

Common Reasons for Denial

! Prior authorization required
! Not meeting high-risk criteria
! Preferred RSV preventive required
! Age/timing criteria not met
! Dosing/administration concerns
! New drug with limited coverage policies

How We Help

We help you document your infant's RSV risk factors, age eligibility, and why RSV prevention is medically necessary for protecting your baby.

Start your Enflonsia appeal — it takes about 3 minutes.

Some Types of Evidence We Can Use For Supporting Your Appeal

✓ Clesrovimab is a long-acting monoclonal antibody that neutralizes RSV, preventing severe lower respiratory tract infection.

✓ RSV is the leading cause of infant hospitalization in the United States.

✓ Clinical trials demonstrated significant reduction in medically attended RSV infections.

✓ Single-dose administration provides protection throughout the RSV season.

Patient Assistance & Copay Programs

These programs may help reduce your costs while you appeal:

Merck Patient Assistance

Merck offers patient assistance programs for eligible patients. Contact Merck for Enflonsia-specific assistance information.

Eligibility requirements and program terms may change. Please verify current details directly with each organization.

Patient Advocacy & Support Organizations

These organizations provide education, support, and advocacy for patients:

American Lung Association

Leading organization fighting lung disease including RSV through research and advocacy.

Frequently Asked Questions

RSV preventives are recommended for all infants under 8 months entering their first RSV season, and for certain high-risk infants up to 19 months. Your pediatrician can determine eligibility.

RSV preventives are typically covered under medical benefits (like vaccines) rather than pharmacy benefits. Check with your insurance about specific coverage.

Ready to Fight Your Enflonsia (clesrovimab) Denial?

Our free AI-powered tool will help you generate a compelling appeal letter in minutes.

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Disclaimer: Fight Health Insurance is not affiliated with, endorsed by, or partnered with any pharmaceutical manufacturer, healthcare provider, medical device company, or patient assistance program, including Merck & Co.. All information provided is for educational and informational purposes only and does not constitute medical or legal advice. Please consult with your healthcare provider regarding treatment options and with your insurance company regarding coverage decisions.