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$0 co-pay card

It's simple to sign up for the savings you need

With the MULTAQ Savings Card, you may be eligible for a $0 co-pay on each of your next 12 MULTAQ prescriptions for savings of up to $150 commercial benefit per prescription. For cash payments, you may be eligible for $50 off on your next 12 MULTAQ prescriptions.*

To see if you qualify for the MULTAQ Savings Card, or to activate your card, please answer the following questions.

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Please enter a valid e-mail address

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There seems to be an issue with this card number. Please call the LoyaltyScript® for Sanofi MULTAQ® Copay Savings at 855-820-0275.

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Savings Card authorization

To assist us with validating your eligibility for this offer, please answer the following questions designed to help determine if you are a Federal Healthcare Program beneficiary (whether you receive Medicare, Medicaid, etc).

Please select ‘Yes’ or ‘No’ You must be a US resident to qualify.

Please select ‘Yes’ or ‘No’ You must not be receiving Medicaid to qualify.

  • You are 65 years of age or older and neither you nor your spouse is working; or
  • You are receiving Social Security payments because of a disability; or
  • You have end-stage renal disease
Please select ‘Yes’ or ‘No’ You must not be receiving Medicare to qualify.

Please select ‘Yes’ or ‘No’ You must not be in the military to qualify.

*Qualifying patients are eligible for a maximum of 12 benefits per calendar year. Depending on your out-of-pocket costs, the benefit may vary. Card carries a maximum commercial benefit of $150 per prescription for up to 12 prescriptions (maximum of $1,800) per calendar year. Eligible cash patients will receive $50 off for a maximum of 12 benefits per calendar year. Sanofi US reserves the right to rescind, revoke, or amend this offer without notice. Certain restrictions apply. See details on savings card.

This offer is not valid for prescriptions covered by or submitted for reimbursement under Medicaid, Medicare, VA, DOD, TRICARE, or similar federal or state programs including any state pharmaceutical assistance program. Should you begin receiving prescription benefits from any federal, state, or government funded program at any time, you will no longer be eligible to participate in this program.

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Congratulations. You qualify for the MULTAQ Savings Card

Please complete the next two steps to finish your registration for savings.

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First name is required Last name is required
Please enter a valid date of birth You must be 18 years or older to register
Please select ‘Male’ or ‘Female’
Please enter a valid phone number
Please enter your address
Please enter your city
Please select your state
Please enter a valid five-digit ZIP code
Valid e-mail address required This email address already exists in our system.
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Download or print your Savings Card