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Now you can:

  • Pay as little as $0 for your monthly prescription*
  • Access your savings card on your mobile phone
  • Take advantage of savings on other participating AstraZeneca medications
AZhelps Savings Card offers as low as $0 for as long as your doctor prescribes, subject to eligibility

FARXIGA SavingsRx Card offers as low as [$0] for as long as your doctor prescribes, subject to eligibility

EVERY MONTH FREE*

For commercially insured patients

*Savings subject to monthly limit. Subject to eligibility. Restrictions apply.
Not available for government-insured patients.

FARXIGA SavingsRx Card offers as low as [$0] for as long as your doctor prescribes, subject to eligibility

EVERY MONTH FREE*

For commercially insured patients

*Savings subject to monthly limit. Subject to eligibility. Restrictions apply.
Not available for government-insured patients.

SAVE INSTANTLY*

AT YOUR PHARMACY

THROUGH THE MAIL

 

*Subject to eligibility. Restrictions apply. See below for details.

If eligible, show your card and prescription to your pharmacist for instant savings.

AT YOUR PHARMACY

Commercially insured patients can get FARXIGA for as low as $0 per month for as long as your doctor prescribes any available dose.

Download this card and present it with your prescription to the pharmacist at your retail pharmacy. If you use a mail order pharmacy, call to confirm that they accept the savings card. Once they receive your prescription and process your payment, provide your savings card ID number to receive a check.

THROUGH THE MAIL

IF YOUR MAIL ORDER PHARMACY DOESN’T ACCEPT THE SAVINGS CARD, YOU CAN STILL SAVE!

FILL OUT A PATIENT REBATE FORM

MAIL IT

  1. Attach the original mail order receipt to the rebate form and mail it to the address listed on the form
  2. Keep a copy of your receipt for your records

RECEIVE YOUR CHECK IN ABOUT 6 TO 8 WEEKS

Repeat these steps each time you refill your prescription to receive your check

ELIGIBILITY AND TERMS OF USE

ELIGIBILITY: You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions. Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient. This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age.

TERMS OF USE: Eligible commercially insured patients with a valid prescription for FARXIGA® (dapagliflozin) who present this savings card at participating pharmacies will pay $0 per 30-day supply subject to a maximum savings of $481 per 30-day supply. If you pay cash for your prescription, AstraZeneca will pay up to the first $150, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply. Patient is responsible for applicable taxes, if any. Non-transferable, limited to one per person, cannot be combined with any other offer. Void where prohibited by law, taxed or restricted. Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer. AstraZeneca reserves the right to rescind, revoke, or amend this offer, eligibility and terms of use at any time without notice. This offer is not conditioned on any past, present or future purchase, including refills. Offer must be presented along with a valid prescription at the time of purchase. If you have any questions regarding this offer, please call 1-844-631-3978.

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

 

Prescription coverage support

Find answers to questions about prescription coverage ›

ELIGIBILITY AND TERMS OF USE

ELIGIBILITY:

You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions. Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient. This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age.

TERMS OF USE:

Eligible commercially insured patients with a valid prescription for FARXIGA® (dapagliflozin) who present this savings card at participating pharmacies will pay $0 per 30-day supply subject to a maximum savings of $481 per 30-day supply. If you pay cash for your prescription, AstraZeneca will pay up to the first $150, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply. Patient is responsible for applicable taxes, if any. Non-transferable, limited to one per person, cannot be combined with any other offer. Void where prohibited by law, taxed or restricted. Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer. AstraZeneca reserves the right to rescind, revoke, or amend this offer, eligibility and terms of use at any time without notice. This offer is not conditioned on any past, present or future purchase, including refills. Offer must be presented along with a valid prescription at the time of purchase. If you have any questions regarding this offer, please call 1-844-631-3978.

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

 

Prescription coverage support

Find answers to questions about prescription coverage ›