SAVINGS CARD
for as little as
$0
A MonthOnce enrolled, here’s what you can expect:
quick, affordable access to Qulipta
Eligible commercially insured patients pay as little as $0 a month. If you experience an insurance delay or denial, eligible patients can receive QULIPTA shipped directly to their door*
quick, affordable access to Qulipta
Eligible commercially insured patients pay as little as $0 a month. If you experience an insurance delay or denial, eligible patients can receive QULIPTA shipped directly to their door*
quick, affordable access to Qulipta
Eligible commercially insured patients pay as little as $0 a month. If you experience an insurance delay or denial, eligible patients can receive QULIPTA shipped directly to their door*
Questions? Support is only a phone call away. Call 1-855-QULIPTA (1-855-XXXXX) Monday through Friday, 8AM-8PM ET
*Terms and Conditions apply. This benefit covers QULIPTA. Eligibility: Available to patients with commercial prescription insurance coverage for QULIPTA who meet eligibility criteria. Copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the QULIPTA Patient Savings Program Card and patient must call QULIPTA at 1-800-QULIPTA and stop use of the copay card. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from QULIPTA Patient Savings Program, including the copay card, from any third-party payers. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums, may apply. This is not health insurance.
1. ENROLL NOW
- Click the button below and provide the requested information. You can start using your savings card right away!
2. START SAVING
- Eligible, commercially insured patients can pay as little as $0 a month*
- If you experience issues with insurance coverage, we offer additional support options to help eligible patients get QULIPTA
3. GET SUPPORT
- QULIPTA Complete Insurance Specialists will help you understand your insurance coverage and identify the next steps to getting your prescribed treatment
- QULIPTA Complete Support Specialists can answer your questions about QULIPTA, and help you establish a daily routine to achieve your personal goals†
For eligible, commercially insured patients.
Terms, Conditions, and Eligibility Criteria apply.*
Home delivery may be an option for you. Contact your pharmacy or insurance provider to learn more.
Questions? Support is only a phone call away. Call 1-855-QULIPTA (1-855-785-4782) Monday through Friday, 8 AM-8 PM ET
If you’ve already paid out of pocket for QULIPTA and would like to request reimbursement, visit Complete Rebate
If you’ve enrolled or a healthcare provider has processed your enrollment, what’s next?
A QULIPTA Complete Support Specialist will call you directly to help you navigate your insurance options, and help you access QULIPTA
If you miss the call or have questions, call us at 1-855-QULIPTA, Monday–Friday, 8 AM to 8 PM ET
Terms and Conditions apply. This benefit covers QULIPTA® (atogepant). Eligibility: Available to patients with commercial insurance coverage for QULIPTA who meet eligibility criteria. Co-pay assistance program is not available to cash paying patients or patients receiving reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving drug coverage under any such federal, state, or government-funded healthcare program, the patient will no longer be able to use the Qulipta Complete Savings Card and patient must call 1-855-QULIPTA to stop participation. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from the Qulipta Complete Savings Card from any third-party payers. Offer subject to change or discontinuation without notice. Restrictions, including monthly maximums, may apply. Subject to all other terms and conditions, the maximum annual benefit that may be available solely for the patient’s benefit under the co-pay assistance program where coverage is available is $6,000 per calendar year. Patients may be eligible to receive up to 12 30-day fills at no charge where coverage is not available until the insurer has established a coverage review process. Under this program, once an insurer has established a review process for coverage requests, eligible patients may receive up to a maximum of 2 30-day fills at no charge for an FDA-approved indication while coverage is pending. The actual application and use of the benefit available under the co-pay assistance program may vary on a monthly, quarterly, and/or annual basis, depending on each individual patient’s plan of insurance and other prescription drug costs. This assistance offer is not health insurance. By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer. To learn about AbbVie’s privacy practices and your privacy choices, visit https://privacy.abbvie.
To Pharmacists: For further information, please contact 800-364-4767.