Revatio Savings Card

Funded

About

The Revatio Savings Card program offers significant savings for patients using the drug Revatio, with eligible patients potentially paying as little as $0 per 30-day prescription. The program provides savings of up to $1,000 per fill and maximum annual savings of $12,000. The Revatio Savings Card ensures affordability and accessibility for patients with private insurance coverage for Revatio.

Insurance requirements: Commercially insured

Enrollment Forms

Enrollment Form

Benefits

•$12000 annual maximum benefit

•12 maximum fills per year

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Must be 18 years of age or older

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: No

•Activation Required: No

Program Details

•Eligible patients may pay as little as $0 per 30day prescription with savings of up to $1000 per fill; maximum savings of $12,000 per year

•Temporary card can be printed for immediate use following online eligibility and enrollment; permanent card should arrive by mail in 34 weeks

•Card may be used once per month for the life of the program, and cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription

•Card will be accepted only at participating pharmacies, and is limited to 1 per person during this offering period and is not transferable

•For further information, call 18667324468, visit REVATIO.com, or write: Viatris Inc., P.O. Box 2941, Mission, KS 66201

Enrollment Forms

Enrollment Form