What is XELJANZ/XELJANZ XR?

XELSOURCE SM

XELSOURCE offers support to help you get started with your XELJANZ prescription. When you call, you can speak to someone about your insurance coverage and medication costs. XELSOURCE may have options to help eligible patients afford XELJANZ. Terms and conditions/eligibility requirements apply.
1CONTACTING XELSOURCE

To speak with someone, Monday through Friday, 8:00 AM–8:00 PM ET, call 1-844-XELJANZ (1-844-935-5269).

Automated services, such as activating a Co-Pay Savings Card for eligible patients, are available 24 hours a day, 7 days a week. Simply call XELSOURCE and say “Activate.”

2GETTING STARTED

When you’re starting out on a prescription XELJANZ treatment for RA, support programs from XELSOURCE may help by:

  • When required, assisting you with obtaining Prior Authorization (PA).
  • When needed, helping you investigate and assess your eligibility for coverage.
3FINANCIAL SUPPORT

XELSOURCE may help by contacting your insurance company on your behalf to understand your insurance benefits for XELJANZ, including what your out-of-pocket costs will be.

FREQUENTLY ASKED QUESTIONS

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

  • If you have government insurance, such as Medicare Part D and Medicaid, or if you need financial assistance, we can also evaluate your eligibility for the Pfiizer Patient 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 and need financial assistance, we will evaluate your eligibility for the Pfizer Patient Assistance Program.* If you are eligible we will provide you XELJANZ at no cost to you. See terms and conditions/eligibility requirements.

*The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance Foundation™. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions.

To speak with a XELSOURCE specialist about what options may be available to you, call 1-844-XELJANZ (1-844-935-5269), Monday through Friday, 8:00 AM–8:00 PM ET.

If you are new to XELJANZ, your healthcare provider can request a free, 14-day trial prescription for you. See terms and conditions/eligibility requirements.

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 terms and conditions/eligibility requirements.

If you qualify for a Co-Pay Savings Card, it can be used for either XELJANZ or XELJANZ XR.

When switching from XELJANZ to once-daily XELJANZ XR additional approvals may not be required. For more information, check with your insurance provider.

Once your new plan begins, XELSOURCE may help by contacting your insurance company on your behalf to understand your insurance benefits for XELJANZ, including what your out-of-pocket costs will be.

If your request is denied, you may able to appeal the decision. Call XELSOURCE for help navigating the approval process and to learn more about the support programs that may be available to you.

To speak with a XELSOURCE specialist, call 1-844-XELJANZ (1-844-935-5269), Monday through Friday, 8:00 AM–8:00 PM ET.

Co-Pay Savings Card

Our Co-Pay Savings Card may make XELJANZ XR more affordable for eligible patients with private insurance. Terms and conditions/eligibility requirements apply.

 

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 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 1-844-XELJANZ (1-844-935-5269) and say “Activate.”

*For patients who do not have private insurance, XELSOURCE may offer financial assistance for government-funded and uninsured patients through the Pfizer Patient Assistance Program. Call XELSOURCE to learn more about these programs. Terms and conditions/eligibility requirements apply.