Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
2 Programs for Lipitor Tablets
 
 
Lipitor Choice Co-Pay Program

LIPITOR Choice Card
14001 Weston Parkway, Suite 103
Cary, NC 27513
Phone : 800-314-7957
Fax:
Eligibility
> This is a copay assistance program for patients that have private insurance. Patients with government funded insurance are not eligible. Patient with Medicare Part D are eligible but must contact the program for details. There are no income requirements for this program. MA residents are not eligible.
Who Can Apply
> Patients or healthcare providers can call to complete by phone or complete online.
Required
> Patients must enroll online or by phone and doctors must provide a prescription.
Supply
> Not applicable
Ship To
> Patient sent card to be used at pharmacy
Note
> Program expires 12/31/16 This card is only valid at participating pharmacies. The maximum savings is $2500 per year. To qualify for this offer your out-of-pocket expense must be more than $4 per prescription.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Lipitor Tablets
 
 
 
Xubex Pharmaceutical Services

PO Box 1244
Winter Park, FL 32790-1244
Phone : 866-699-8239
Fax: 407-671-7960
Eligibility
> Patients may have insurance. There are no income limits for this program. Patients must be a US resident.
Who Can Apply
> Anyone requesting assistance can call to request a faxed application or download it from the website.
Required
> The doctor needs to provide a prescription to the patient.The patient must fill out a section and sign the application.
Supply
> Varies
Ship To
> Either Doctor's office or Patient's home
Note
> No proof of income is required. Check the website for the exact price. This service is not currently available in Montana.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Lipitor Tablets
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
(Requires Acrobat Reader