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.
ELIGIBLE COMMERCIALLY INSURED PATIENTS MAY PAY AS LITTLE AS $0* WITH THE QULIPTA COMPLETE SAVINGS CARD
Sign up for a QULIPTA Complete Savings Card to save
every time you go to the pharmacy for QULIPTA
Two steps to savings:
Save your card to your phone, then show it to the pharmacist when you pick up your prescription
You can save the card to your mobile wallet so you always have it handy when you pick up your prescription.
*Eligibility: Available to patients with commercial insurance coverage for QULIPTA® (atogepant) who meet eligibility criteria. This 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. Offer subject to change or termination without notice. Restrictions, including monthly maximums, may apply. This is not health insurance. For full Terms and Conditions, visit QULIPTASavingsCard.com. For additional information, call 1-855-QULIPTA (1-855-785-4782). To learn about AbbVie’s privacy practices and your privacy choices, visit https://privacy.abbvie.
QULIPTA COMPLETE OFFERS:
Savings on QULIPTA
for eligible commercially
insured patients
Help with
insurance questions
Treatment tools
like symptom trackers
and refill reminders
LOST YOUR SAVINGS CARD?
TEXT‡ SAVE TO 785478 AND WE
WILL RESEND.
If you have additional questions, you can call 1-855-QULIPTA (1-855-785-4782).
If you’ve already paid out of pocket for QULIPTA and would like to request reimbursement, visit Complete Rebate.
†Qulipta Savings Card Terms and Conditions
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.
‡Msg and data rates apply. Msg frequency depends on user. Reply HELP for help; reply STOP to cancel. Consent to texts not required to sign up for offer.
To Pharmacists: For further information, please contact 1-800-364-4767.