Prograf Copay Card

With the Prograf Copay Card, the copay is $0.a  This Prograf Copay Card provides your patients with savings of up to $200 per individual strength per month for up to 12 prescriptions at the pharmacy.a The Prograf Copay Card is valid for twelve (12) months from date of enrollment. Annual re-enrollment in the Prograf Copay Card Program is required and subject to eligibility. Restrictions may apply.

Patients may receive the Copay Card in one of two ways:

  1. Directly from their healthcare provider
  2. Online at www.transplantmedsavings.com/immediate,
    • Eligible Patients will be able to download and print a temporary card that can be activated immediately from the Web site
    • Subsequently, a Copay Card will be sent to the patient in the mail

The enrollment process is simple. The patient calls the Prograf Copay Card Support Line at 1-866-790-7659 and provides the following information:

  • 9-digit ID number on the Copay Card
  • Phone number
  • Name
  • Email address
  • Home address, city, and state in which patient resides
  • Date of birth
  • Federal Health Care Program Status (e.g. Medicare, Medicaid, Medigap, VA, DOD, or TriCare)

Once the patient has provided this information, the Prograf Copay Card will be activated if the patient meets eligibility criteria. To receive the instant rebate, the patient simply needs to present the Prograf Copay Card to the pharmacy.

Patients who receive their Prograf prescriptions by mail can also take advantage of the Prograf Copay Card. Patients may utilize our mail-in option by filling out the "Mail Order" card within the Prograf Copay Card brochure, or by visiting www.patientrebateonline.com.



aEligible participants in the Prograf Copay Card Program ("Program") may receive savings of up to $200 each month for each individual prescription strength of Prograf. Patient is responsible for any differential over $200 for each individual prescription strength. Program offer not valid for those who participate in any federal or state funded prescription drug benefit program (e.g. Medicare, Medicaid, Medigap, VA, DOD, or TriCare). Patients who reside in the state of Massachusetts are not eligible to participate in the Program. The Prograf Copay Card is valid for twelve (12) months from date of enrollment. Annual reenrollment in the Program is required and subject to eligibility. Restrictions may apply.


PLEASE SEE INDICATION AND IMPORTANT SAFETY INFORMATION HERE.
PLEASE SEE FULL PRESCRIBING INFORMATION, INCLUDING BOXED WARNINGS HERE.

eService

Apply online for patient assistance quickly and easily

Quarterly Updates

Get the latest coding and billing information for Astellas products

Coverage Wizard

Find Information about Medicare and Medicaid coverage In your state