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What is XELJANZ/XELJANZ XR?

ABOUT XELSOURCE SM

If you have been prescribed XELJANZ by your doctor, and you are having difficulty affording XELJANZ, XELSOURCE may have options to help you get started with your XELJANZ prescription. See below for details.Terms and conditions/eligibility requirements apply.
1CONTACTING XELSOURCE

To speak with someone at XELSOURCE about your insurance coverage and medication costs for XELJANZ/XELJANZ XR, Monday through Friday 8:00 AM–8:00 PM ET, call 1-844-935-5269 and say “Representative.”

2GETTING STARTED

After you have been prescribed XELJANZ/XELJANZ XR, our support program may help you by:

  • Contacting your insurance company on your behalf
  • Helping investigate and assess your eligibility for coverage when needed
  • Confirming what your out-of-pocket costs will be
  • Assisting you with obtaining Prior Authorization (PA) when needed
3ACTIVATING CO-PAY SAVINGS CARD

Our Co-Pay Savings Program may reduce out-of-pocket-cost for eligible, commercially insured patients prescribed XELJANZ/XELJANZ XR. Eligibility requirements apply.

To speak with someone about your insurance coverage and medication costs, call 1-844-935-5269 and say "Representative."

Learn About Savings Options

If you have been prescribed XELJANZ and you are running into financial challenges, Pfizer has programs in place that may be able to help. See below for details.

If you have commercial insurance, you may qualify for a Co-Pay Savings Card. See limits, terms, and conditions. If your pharmacy does not accept the Co-Pay Savings Card, a rebate form is available. Eligibility is not based on income.

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

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/XELJANZ XR at no cost to you. See limits, terms, and conditions.

To speak with someone at XELSOURCE about your insurance coverage and medication costs for XELJANZ, call 1-844-935-5269 and say “Representative.”

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

Financial Support Questions

Commercial patients prescribed XELJANZ or XELJANZ XR should call XELSOURCE at 1-844-935-5269 to determine if they qualify for a Co-Pay Savings Card. Terms and conditions can be accessed here.

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

Health plans can change—so can your health insurance and prescription benefits. Once your new plan begins, XELSOURCE can help review your plan information, verify your coverage if needed, and assist with the Prior Authorization (PA) process.

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

To speak with a XELSOURCE specialist about what savings options may be available to you, call 1-844-935-5269, Monday through Friday, 8:00 AM–8:00 PM ET, and say “Representative.”

Co-Pay Savings Card

Our Co-Pay Savings Card may reduce out-of-pocket cost for eligible, commercially-insured patients prescribed XELJANZ/XELJANZ XR. Terms and conditions/eligibility requirements apply.

Sign Up To Receive A Co-Pay Savings Card Now

There are three ways you can get a Co-Pay Savings Card.*

  1. 1. Receive one in the mail, as part of our XELJANZ Welcome Kit.
  2. 2. Elect to receive one via text message by texting “XPROGRAM” to 50336 and enrolling in the XSAVINGS Co-pay Program for XELJANZ.
  3. 3. Follow the directions to print a card immediately after registering below.

To activate your card, call 1-844-935-5269 and say “Activate.”

*For eligible underinsured or uninsured patients, XELSOURCE may offer financial assistance through the Pfizer Patient Assistance Program. Call XELSOURCE to learn more about these programs. Terms and conditions/eligibility requirements apply.

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