XARELTO withMe Coverage Gap Support Program Requirements
You may be eligible for the XARELTO withMe Coverage Gap Support if you:
- Have insurance covering a portion of the cost of XARELTO®
- Are being asked to pay more than $89 monthly for XARELTO® through your insurance
Other Requirements
XARELTO withMe Coverage Gap Support is only available for people who are taking XARELTO® as prescribed for FDA-approved, on-label use. It is not valid for any prescription written with off-label dosing.
XARELTO withMe Coverage Gap Support is not insurance and should not take the place of insurance.
To register, you must have insurance covering a portion of the cost for XARELTO®, and you are being asked to pay more than $89 monthly for XARELTO® through your insurance. The amount you pay ($89 or $250, plus sales tax if applicable) will not count toward your deductible or cumulative out-of-pocket spend. The amount you pay may not be submitted as a claim for payment to any third-party payer or pharmaceutical patient assistance foundation. If you choose, you may submit the amount you pay to a Flexible Spending Account (FSA) or a Health Savings Account (HSA). Check with your employer if the amount you pay may be submitted to a Health Reimbursement Account (HRA).
Registration begins April 1 each year and refills are available through December 31. Terms expire at the end of each calendar year and may change.
Before you register for XARELTO withMe Coverage Gap Support, it is important you understand that you will be asked to provide personal information that may include your name, address, phone number, email address, and information related to your prescription insurance and treatment. This information will be used by the mail-order pharmacy for Coverage Gap Support, in accordance with their privacy practices, to determine your eligibility, and, if eligible, enroll you in XARELTO withMe Coverage Gap Support, and administer XARELTO withMe Coverage Gap Support. The information will also be used to learn more about the people who use XARELTO withMe Coverage Gap Support and improve the information we give them. It will be shared with companies supporting XARELTO withMe Coverage Gap Support and your insurance provider, as required by law.
XARELTO withMe Coverage Gap Support may not be used with any other coupon, discount, prescription savings card, free trial, or other offer. Offer good only in the United States and Puerto Rico. Void where prohibited or limited by law.
You may end your participation in XARELTO withMe at any time by calling 888-XARELTO (888-927-3586), Monday–Friday, 8 AM to 8 PM ET.
XARELTO withMe Savings Card Program Requirements
You may be eligible for the XARELTO withMe Savings Card if you:
- Use commercial or private health insurance to pay for your XARELTO® prescription
- Are being treated with XARELTO®, except if you are prescribed XARELTO® 10 mg because of a recent non-surgical hospital discharge or because you have recently undergone hip or knee replacement surgery
Other Requirements
The XARELTO withMe Savings Card is only for people using commercial or private health insurance for XARELTO®. This includes plans from the Health Insurance Marketplace. The XARELTO withMe Savings Card is not for people who use any state or federal government-funded healthcare program. Examples of these programs are Medicare, Medicaid, TRICARE, Department of Defense, and Veterans Administration. You may not seek payment for the value received from XARELTO withMe from any health plan, patient assistance foundation, flexible spending account, or healthcare savings account. You must meet the Savings Card requirements every time you use the card. Terms will expire at the end of each calendar year. The XARELTO withMe Savings Card may change or end without notice, including in specific states.
To use the XARELTO withMe Savings Card, you must follow any health plan requirements, including telling your health plan how much co-payment support you get from XARELTO withMe. By using the Savings Card, you confirm that you have read, understand, and agree to the requirements on this page, and you are giving permission for information related to your Savings Program transactions to be shared with your healthcare provider(s). These transactions include rebates and any funds placed on the card or balance remaining on the card.
Before you enroll for the XARELTO withMe Savings Card, you will be asked to provide personal information that may include your name, address, phone number, email address, and information related to your prescription medication insurance and treatment. This information is needed for Johnson & Johnson Health Care Systems Inc. and our service providers to enroll you for the XARELTO withMe Savings Card. We may also use the information you give us to learn more about the people who use XARELTO® and to improve the information we give them. Johnson & Johnson Health Care Systems Inc. will not share your information with anyone else except where legally allowed.
This offer may not be used with any other coupon, discount, prescription savings card, free trial, or other offer. Offer good only in the United States and its territories, including Puerto Rico. Void where prohibited, taxed, or limited by law.
You may end your participation in XARELTO withMe at any time by calling 888-XARELTO (888-927-3586) , Monday–Friday, 8 AM to 8 PM ET.
XARELTO withMe Savings Card Terms & Conditions
Eligible commercially insured patients pay as little as $10 per fill. There is a limit to savings per fill. Savings may apply to co-pay, co-insurance, or deductible. Participate without sharing your income information. Your final out-of-pocket cost after the Savings Card is applied will depend on your insurance plan and pharmacy.
You will receive personalized refill notifications that will remind you when you are close to needing a refill or late to refilling your prescription of XARELTO®. You can opt out from receiving notifications anytime by calling 888-XARELTO (888-927-3586).
Pharmacists: Please see below for processing instructions.
Non-Transferable. Patient must submit a valid prescription.
Patient: Present this offer along with a signed prescription for XARELTO®. You must meet the Savings Card requirements every time you use the card. By using the Savings Card, you confirm that you have read, understand, and agree to the program requirements shown below and at XARELTOwithMe.com/SavingsCard. This offer is provided to you as a service by Johnson & Johnson Health Care Systems Inc. Terms will expire at the end of each calendar year. The XARELTO withMe Savings Card may change or end without notice, including in specific states. The XARELTO withMe Savings Card is only for people using commercial or private health insurance for XARELTO®. This includes plans from the Health Insurance Marketplace. The XARELTO withMe Savings Card is not for people who use any state or federal government-funded healthcare program. Examples of these programs are Medicare, Medicaid, TRICARE, Department of Defense, and Veterans Administration. You may not seek payment for the value received from XARELTO withMe from any health plan, patient assistance foundation, flexible spending account, or healthcare savings account. To use the XARELTO withMe Savings Card, you must follow any health plan requirements, including telling your health plan how much co-payment support you get from XARELTO withMe.
Pharmacist: For insured patients, process a Coordination of Benefits (COB/split bill) claim using the patient’s prescription insurance for the PRIMARY claim. Submit SECONDARY claim to PDM under BIN # 610020. You will be reimbursed for the face value of the offer plus a dispensing fee, provided you and the customer have complied with the terms of this offer. Cash value: 1/20¢. No alterations of this offer will be accepted. Out-of-pocket cost assistance may not exceed patient’s out-of-pocket cost or amount set by the program’s limits, whichever is less. For questions regarding setup, claim transmission, patient eligibility, registration, or other issues, call 866-736-8081, Monday–Sunday, 8 AM to 12 AM ET.
Offer valid only for the product indicated. Any other use may constitute fraud. The selling, purchasing, trading, or counterfeiting of this card is prohibited by federal law, and such activities may result in imprisonment for not more than 10 years or fines not more than $250,000, or both. OFFER CANNOT BE COMBINED WITH ANY OTHER COUPON, DISCOUNT, PRESCRIPTION SAVINGS CARD, FREE TRIAL, OR OTHER OFFER. Customer is responsible for any sales tax. Tax charged on pre-offer price where required. This offer may not be redeemed for cash. Offer good only in the United States and its territories. Void where prohibited, taxed, or limited by law.
XARELTO withMe is limited to education about XARELTO®, its administration, and/or the condition it treats. It is not intended to provide medical advice, replace a treatment plan you receive from your doctor or nurse, or serve as a reason for you to start or stay on treatment.
Text Message Terms & Conditions
By opting in to receive text messages about XARELTO withMe (the “Program”), you consent to receive autodialed text messages on behalf of Johnson & Johnson Health Care Systems Inc. (“JJHCS”). In certain messages, XARELTO withMe will be shortened to XWM Support for space and privacy purposes. You are not required to provide your permission to receive text messages (SMS) to participate in the Program or to receive any other communications you have selected. The text messaging service is valid with most major US carriers. See Supported Carriers list below. There is no fee payable to JJHCS to receive text messages. However, your carrier’s message and data rates may apply. Message frequency varies.
The data you provide will be used by JJHCS to provide the text message services you request. Our Privacy Policy governs the use of the information you provide.
You may unsubscribe from text messages at any time by replying STOP to any message you receive. A message will be sent to your mobile number confirming the cancellation, but no more text messages will be sent from this Program after that one, unless you opt in to receive text messages in the future.
If you are experiencing issues with the messaging program you can reply with the keyword HELP to any message you receive, or you can get help directly at 877-227-3728.
For questions about the Program, visit XARELTOwithMe.com.
Supported Carriers
The text message service is available on the following carriers:
Appalachian Wireless, AT&T, Bluegrass Cellular, Boost Mobile, Cellcom, Cellular South, Centennial Wireless, GCI, Immix Wireless, Inland Cellular, IV Cellular, Nex-Tech Wireless, nTelos, Metro PCS, Sprint, T-Mobile®, U.S. Cellular, United Wireless, Verizon Wireless, Virgin Mobile USA, and West Central Wireless.
T-Mobile is not liable for delayed or undelivered messages.