www.eliquis.com Activate Co-pay Card for ELIQUIS

If you are eligible, the Co-pay Card may be available for ELIQUIS (apixaban).

  1. Commercial insurance covers you, but your prescription insurance does not cover all the cost of your prescription. You have a copay obligation for ELIQUIS.
  2. Prescription insurance coverage is not available through any state or federal program. This includes but not limited Medicare Part D, Medicaid and Medigap. Patients who change from commercial plans to state- or federally funded healthcare programs will not be eligible.
  3. You must be 18 years old or older.
  4. You are a Puerto Rican resident.

www.eliquis.com Activate Card

  1. To Activate the Card please visit the site https://www.activatethecard.com/eliquis/
  2. Now log in with your 7-digit NCPDP Code and click SUBMIT.
  3. This site is only for pharmacists and pharmacy administrators.

Eliquis 30-Day Free Trial and Terms of UseELIGIBILITY REQUIRED:

If:

  1. You have never previously filled a prescription to ELIQUIS.
  2. A valid prescription is available for ELIQUIS within 30 days.
  3. ELIQUIS is being used to treat an FDA-approved indication in which an HCP has planned for treatment for over 35 days;
  4. You must be 18 years old or older.
  5. You are a citizen of Puerto Rico or the United States.

TERMS OF USE

  1. Patients who are eligible and present a 30-day free trial card along with a valid prescription for ELIQUIS within 30 days at participating pharmacies will be eligible to receive a 30-day supply of ELIQUIS (up to 74 tablets) for free. The patient is responsible for any applicable taxes. Prescriptions that are longer than 30 days may not qualify for this offer.
  2. This offer can only be used once per patient and cannot be transferred. You will be able to redeem this offer and certify that you have never filled a prescription for ELIQUIS.
  3. You cannot combine the 30-day free trial for the prescribed prescription with any other rebate/coupon or similar offer. Substitutions are not allowed.
  4. The 30-day free trial of ELIQUIS is not available to patients, pharmacists, or prescribers.
  5. Patients cannot count the 30-day free trial of ELIQUIS for the purposes of determining out of pocket costs for any plan. This includes true out of pocket costs (“TrOOP”) for the purposes of calculating Medicare Part D’s out-of–pocket threshold.
  6. The December 31st 2022 deadline is required for activation and use. This card will expire on December 31, 2022.
  7. This offer is only valid in the United States of America and Puerto Rico. It is null if prohibited or restricted by law.
  8. Pfizer and Bristol-Myers Squibb reserve the right at any time to cancel, revoke or modify this offer without prior notice.
  9. The 30-day free trial card cannot be sold, bought, traded or counterfeited. This card cannot be reproduced.
  10. This offer does not apply to any previous, present, or future purchases, including refills.
  11. The ELIQUIS 30-Day Free Trial Offer is not for health insurance.