Copay Savings Program

Eligible commercially insured patients may PAY AS LITTLE AS $49
Eligible Medicare patients, cash-paying patients, and patients denied coverage may PAY AS
LITTLE AS $59
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Click on the link below that best describes your insurance coverage

All fields marked with an asterisk are required.

By downloading this card you are verifying that you have commercial insurance and do NOT have Medicare Part D, Medicare Advantage. You also verify that your prescriptions are NOT paid for in part or full by any federally funded program, including Medicaid, Tricare, DOD, and VA.

*Agreement to not seek reimbursement from your Medicare Part D or Medicare Advantage coverage is required to participate.

By downloading this card, you are verifying that you do not have insurance coverage and pay for your prescriptions in cash.

Terms and Conditions:

This program is subject to overall maximum support amounts.

This coupon is not valid for prescriptions paid for in part or full by Medicaid, Tricare, DOD, VA, or any state or federally funded program (excluding Medicare).

Patients who have prescription drug coverage under Medicare Part D or Medicare Advantage may be eligible for this offer, provided that they acknowledge that by doing so they will not seek any prescription coverage or reimbursement from their insurer for the cost of prescriptions, or report any amounts paid for prescriptions as part of their "true out-of-pocket expenses" under Medicare Part D or Medicare Advantage prescription drug plan.