ABOUT XELSOURCE SM

It’s possible that you may encounter challenges from your insurance company when starting treatment. That’s why there’s XELSOURCE*— a team of specialists that can help you navigate the financial aspects of your treatment. If you have questions about paying for your XELJANZ or XELJANZ XR prescription or about dealing with insurance, XELSOURCE can help.
1CONTACTING XELSOURCE

To speak with a live specialist, Monday through Friday, 8:00 AM–8:00 PM ET, call 1-855-4-XELJANZ (1-855-493-5526) and select option 4.

Automated services, such as activating the Co-Pay Savings Card, are available 24 hours a day, 7 days a week. Simply call XELSOURCE and select option 2 to activate a Co-Pay Savings Card.

2STARTING TREATMENT

When you’re starting out on treatment, support services from XELSOURCE can help by:

  • Contacting your insurance company on your behalf
  • Confirming what your out-of-pocket costs will be
  • When required, assisting you with obtaining Prior Authorization
  • When needed, helping to navigate additional insurance processes, such as a benefit investigation (BI)
3GETTING YOUR PRESCRIPTION

Your XELSOURCE specialist can help you with:

  • Finding a place to fill your prescription
  • Providing a reminder when it’s time to refill your prescription
  • Working with you and your pharmacy if your insurance requires reauthorization once you are on treatment
4PAYING FOR TREATMENT

Your XELSOURCE specialist can provide financial support by:

  • Providing guidance based on your type of insurance
  • Helping you understand your benefits as you prepare for Open Enrollment
  • Verifying your coverage if/when your insurance changes
  • Providing more information about potential ways to save:

FINANCIAL HELP QUESTIONS

  • If you have private insurance, you may qualify for a Co-Pay Savings Card and pay out-of-pocket costs as low as $0 per month. If your pharmacy does not accept the Co-Pay Savings Card, or you forgot your card, a rebate form is available. See limits, terms, and conditions. Eligibility is not based on income.

  • If you have government insurance, such as Medicare Part D or Medicaid, or if you need more financial assistance, we can also evaluate your eligibility for a Hardship Assistance Program. If you are eligible, we will provide XELJANZ or once-daily XELJANZ XR at no cost to you.

  • If you have no insurance, we will evaluate your eligibility for our Patient Assistance Program. If you are eligible, we will provide XELJANZ or once-daily XELJANZ XR at no cost to you.

To speak with a XELSOURCE specialist about your savings options, call 1-855-4-XELJANZ (1-855-493-5526), Monday through Friday, 8:00 AM–8:00 PM ET, and select option 4.

Yes, if you have a valid prescription and are eligible, your healthcare provider can request a free, 14-day trial prescription for you. See limits, terms, and conditions.

If you are eligible for the Co-Pay Savings Card, but your pharmacy does not accept it, a rebate form is available to reimburse you for the co-pay amount. Instructions on how to redeem are included on the form. See limits, terms, and conditions.

Yes, XELJANZ patients and XELJANZ XR patients may qualify for a Co-Pay Savings Card.

No, no additional insurance approvals are needed when switching from XELJANZ to XELJANZ XR.

Co-Pay Savings Card

The Co-Pay Savings Card is designed to make your medication more affordable for patients with private insurance. If you are eligible, you may be able to receive your medication for as low as $0 out-of-pocket costs per month.

 

Sign Up to Receive a Co-Pay Savings Card Now

When you register for the XELJANZ+You Support Program, there are two ways you can get a Co-Pay Savings Card to save on your next XELJANZ prescription.

  1. In the mail, as part of our Welcome Kit.
  2. By following the directions to print a card immediately after registering.

To activate your card, call 1-855-4-XELJANZ (1-855-493-5526), and select option 2.

Maximum benefit amount of $12,000 per calendar year.

The Co-Pay Savings Card is available only at participating pharmacies. A rebate form is available for non-participating pharmacies. The savings card is not health insurance. No membership fees.
See limits, terms, and conditions.