If Eligible, Start Saving by
Registering for Your Own
XALATAN Co-Pay Card Today!*
Register or activate your card today!
You can register for or activate your card today by clicking here. You can also register for the Vision Matters™ program—a free program just for XALATAN users, by calling 1-800-711-2712.
You’ll receive a free welcome kit, which includes the exclusive $4 Co-Pay Value Card and information about XALATAN. With the exclusive XALATAN $4 Co-Pay Value Card, XALATAN may help you save up to $60 per month off your co-pay or out-of-pocket costs on each refill through 12/31/2014.
The table below shows the potential savings eligible patients may have when using the XALATAN $4 Co-Pay Value Card
Pfizer Helpful Answers
Pfizer Helpful Answers helps uninsured and underinsured patients who need help getting their Pfizer medicines. Visit Pfizer Helpful Answers for information on prescription savings or free medications for patients who qualify.
XALATAN $4 Co-Pay Value Card Terms and Conditions
By using the XALATAN (latanoprost ophthalmic solution) Value Card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:
- The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in
part, by Medicaid, Medicare, or other federal or state healthcare programs including any
state prescription drug assistance programs and the Government Health Insurance Plan
available in Puerto Rico (formerly known as "La Reforma de Salud").
- The Card is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs that reimburse you for the entire cost of your prescription drugs.
- You will receive up to $60 per month off the co-pay or out-of pocket costs, whichever is less through 12/31/2014. Consumer pays first $4 and gets up to $60 benefit per use on quantities of 7.49 mL and below or up to $180 benefit per use on quantities of 7.50 mL and above. Maximum benefit is $720 per calendar year.
- You must deduct the value received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.
- The Card is not valid for Massachusetts residents whose prescriptions are covered in whole or in part by third-party insurance, or where otherwise prohibited by law.
- Cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription.
- The Card will be accepted only at participating pharmacies.
- This Card is not health insurance.
- Offer good only in the U.S. and Puerto Rico.
- The Card is limited to one person during this offering period and is not transferable.
- Pfizer reserves the right to rescind, revoke, or amend the program without notice.
- No membership fees.
- Card and program expire 12/31/14.
- XALATAN $4 Savings Offer, 6501 Weston Parkway, Suite 370, Cary, NC 27513
- Visit XALATAN.com for more information about XALATAN. For help processing this card, call 1-866-562-6147. Pfizer Inc, 235 E. 42nd Street, New York, NY 10017.
*Please click here for full Terms and Conditions. This card is not health insurance and is only accepted at participating pharmacies. No membership fees apply. Card guarantees up to $60 per month off your co-pay through 12/31/2014.
XALATAN $4 Savings Offer
6501 Weston Parkway, Suite 370
Cary, NC 27513