xarelto copay card pdf

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LearnMorePatientAssistanceLearnmoreThescreenisbestviewedinPortraitOrientationfromourHealthEquityFunds?Xarelto®mgXarelto®mg Xarelto®mgXarelto®mg.PresentthiscardtoeveryWelcometoCo-PayRelief!Forcommerciallyinsuredpatientsandthosepayingwithcash,thisoffercovers theamountabove$uptoamaximumbenefitof$oneachfillTicktheprescribeddoseProgramexpires/31/TheBristolMyersSquibbPatientAssistance Foundation(BMSPAF)isanindependent,charitableorganizationthathelpseligiblepatientswhoneedtemporaryhelpobtainingthemedicineslistedonthissite PAFhasestablisheddiseasespecifichealthequityfundsthatprovidefinancialsupporttoeligiblepatientslivingincertaincountiesPleaserotateyourdevicefora betterviewingexperienceVALTOCOisaprescriptionmedicineusedfortheshort-termtreatmentofseizureclusters(alsoknownas“episodesoffrequentseizure activity”or“acuterepetitiveseizures”)inpatientsyearsofageandolderCopaycardcannotbecombinedwithanyothersavings,freetrialorsimilarofferforthe specifiedprescription.ProgrammanagedbyConnectiveRxonbehalfofAxsomeTherapeutic,Inc.Thepartiesreservetherighttorescind,revokeoramendthis offerwithoutnoticeatanytime., XARELTO®†(rivaroxaban)TabletsororalsuspensionYONDELIS®*(trabectedin)Injectionforintravenoususe*Please seeImportantSafetyInformationandPatientAlertCardVALTOCOisafederallycontrolledsubstance(CIV)becauseitcanbeabusedorleadtodependence Commerciallyinsuredpatientscanpayaslittleas$foraprescriptionfillofMydayisuntiltheendoftheprogramSeeifyouliveinaneligiblecountyandlearnmore aboutthehealthequityfundshereAreyoueligibletogethelpPatientwillberesponsibleforanyprescriptioncostsabove$90whereprohibitedbylawKeepthis cardwithyouatalltimes

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