Copay savings is available to eligible patients with commercial insurance so that they pay only the first $10 of their insurance copay and coinsurance deductibles. Otsuka will pay up to a maximum of $5400. The copay savings is applied directly at the time the prescription is filled at the pharmacy, and the patient will be informed of his or her out-of-pocket cost obligation after the copay savings is applied.
Copay Eligibility Criteria:
- Patients who are commercially insured only, are eligible for commercial co-pay/co-insurance assistance up to a maximum of $5,200 for patients prescribed 15mg tablets and $5,400 for patients prescribed 30mg tablets. Patient is responsible for the first $10.
- Medicare Part D patients, including those with secondary commercial drug coverage, are not eligible for the commercial co-pay assistance program. Medicare Part D and other patients without commercial insurance may receive support for appeals or letters of medical necessity but cannot access financial support, namely co-pay assistance.
- Proof of residency in the United States, including the District of Columbia, Puerto Rico, and the US Virgin Islands is required.
- Patients must currently be receiving medical care from a US-licensed physician.
- Patients must be discharged from the hospital with a prescription for SAMSCA® (tolvaptan).
Call the ASSURE Program™ at 1-855-24-ASSURE (1-855-242-7787) to check eligibility for your patient.
Apply for Additional Coverage Assistance
For patients without adequate insurance coverage, there may be additional assistance available through the Otsuka Patient Assistance Foundation, Inc.
Get Live Access Assistance
Call 1-855-242-7787 to speak with an Assure Site Coordinator, who can help answer access questions.