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Savings 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 with maximum commercial benefit of $3,000 through 12/31/18 (maximum savings of up to $700 per monthly prescription). For cash payments, you may be eligible for up to $150 off 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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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 for the duration of the program. Depending on the patient's out-of-pocket costs, the benefit may vary. Card carries a maximum benefit of $3,000 towards the out-of-pocket costs of eligible commercially insured patients (maximum savings of up to $700 per monthly prescription). Eligible cash patients will receive up to $150 off per prescription. 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. The Federal Employee Health Benefits (FEHB) Program is not a federal or state government health care program for purposes of this savings 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. This program is not valid where prohibited by law.

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Savings Card

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
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