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Elmiron
12/31/2037
Last Updated: 07/26/2023
Elmiron EarlyAssist Savings Card: Eligible commercially insured patients pay $25 per prescription with a maximum savings of $300 per fill; maximum savings of $3,600 per year; offer expires at the end of each calendar year; for additional information contact the program at 800-526-7736.
- Prescription
- Offer Type: Copay Card Download
- Activate By: No Form - Just Print
- Coverage Requirments:
- Pharmacy Support Number 855-434-6285
Depend Real Fit Underwear for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Botox
12/31/2037
Last Updated: 10/23/2023
Botox Alle Points Program: Register and earn points redeemable for savings on certain in-office treatments as well as earn exclusive members-only rewards; for additional information contact the program at 888-912-1572.
- Prescription
- Offer Type: Discount Program/Point System
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 888-912-1572
Depend Shields for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Poise Incontinence Pad Products
12/31/2037
Last Updated: 11/21/2023
Sign-up with an email address to receive coupons for Poise products.
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-947-6473
Poise Incontinence Pad Products
12/31/2037
Last Updated: 11/21/2023
Sign-up with an email address to receive coupons for Poise products.
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-947-6473
Tena Personal Care Incontinence Products
12/31/2037
Last Updated: 08/10/2023
Tena Autobuy & Save Program: Products delivered on a recurring basis will receive a 15% discount; all orders over $50 will receive free shipping; for additional information contact the program at 866-275-8362.
- Over-the-counter
- Offer Type: Discount Program/Point System
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 866-275-8362
Depend Unisex Night Defense Underpads
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Bed Protectors/Underpads (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Real Fit Underwear for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Real Fit Product (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Guards for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Silhouette Underwear Products for Women
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Silhouette Product (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Tena Personal Care Incontinence Products
12/31/2037
Last Updated: 08/10/2023
Sign-up with an email address to receive special offers for Tena products; sign-up link is found at the bottom of the page.
- Over-the-counter
- Offer Type: Sign-up/receive future savings
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 866-275-8362
Tena Personal Care Incontinence Products
12/31/2037
Last Updated: 08/10/2023
Receive a FREE Trial Kit of Tena Personal Care products with registration; limit 1 free trial kit per customer per year and 4 free trial kits per lifetime; for additional information contact the program at 866-275-8362.
- Over-the-counter
- Offer Type: Free-Trial Offer
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 866-275-8362
Conveen Active
12/31/2037
Last Updated: 10/16/2023
Order FREE samples of Conveen products; for additional information contact the program at 800-533-0464.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Patient and Doctor
- Coverage Requirments:
- Pharmacy Support Number 800-533-0464
Myrbetriq
12/31/2037
Last Updated: 10/12/2023
Myrbetriq Momentum Savings Card: Eligible commercially insured patients may receive their 1st prescription FREE and pay as little as $20 with a savings of $70 for each subsequent prescription; maximum savings of $840 for 12 uses; for additional information contact the program at 855-326-1404.
- Prescription
- Offer Type: Copay Card Sign-up
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 855-326-1404
Detrol LA
12/31/2023
Last Updated: 06/29/2023
Detrol LA Savings Card: Eligible patients may pay as little as $0 per prescription with savings of up to $150 per fill; maximum savings of $1800 per year; for additional information contact the program at 855-541-5932.
- Prescription
- Offer Type: Copay Card Sign-up
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 855-541-5932
Retrovir
12/31/2037
Last Updated: 08/02/2023
Retrovir ViiVConnect Savings Card Rebate: Eligible commercially insured patients may submit a rebate if the pharmacy does not accept the Savings Card and the patient paid in full for their prescription; rebate may be completed online or by downloading and mailing in the rebate form; for additional information contact the program at 866-747-1170.
- Prescription
- Offer Type: Mail-In Rebate
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 866-747-1170
Nocdurna
12/31/2037
Last Updated: 07/20/2023
Nocdurna Co-Pay Card: Eligible commercially insured patients may pay as little as $0 per 30-day prescription with a maximum savings of $125 per fill; for additional information contact the program at 855-287-7476.
- Prescription
- Offer Type: Copay Card Download
- Activate By: No Form - Just Print
- Coverage Requirments:
- Pharmacy Support Number 800-364-4767
Tranquility Premium Protection Products
12/31/2037
Last Updated: 10/04/2023
Receive a FREE 2-pack Tranquility product sample by filling out the online form; for additional information contact 866-865-6101.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 866-865-6101
Botox
12/31/2037
Last Updated: 05/11/2023
Botox Savings Program: Eligible commercially insured patients may be reimbursed up to $1000 per treatment with a maximum savings limit of $4000 per year; offer valid for up to 5 treatments over a 12-month period; for additional information contact the program at 800-442-6869.
- Prescription
- Offer Type: Copay Card Sign-up
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 800-442-6869
Detrol LA
12/31/2023
Last Updated: 06/29/2023
Detrol LA Savings Card Rebate: Eligible patients may submit a request for a rebate if the pharmacy does not accept the Savings Card; patient must pay in full for their prescription at the pharmacy before submitting the rebate request; for additional information contact the program at 855-541-5932.
- Prescription
- Offer Type: Mail-In Rebate
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 855-541-5932
Myrbetriq
12/31/2037
Last Updated: 10/12/2023
Myrbetriq Momentum Savings Card: Eligible cash-paying patients may pay as little as $20 with a savings of $70 for each prescription fill; maximum savings of $840 for 12 uses; for additional information contact the program at 855-326-1404.
- Prescription
- Offer Type: Copay Card Sign-up
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 855-326-1404
AZO Cranberry Caplets
12/31/2037
Last Updated: 09/12/2023
Healthcare providers may join the AZO Healthcare Professional Network to be notified of samples for select AZO products.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Doctor/Healthcare Provider
- Coverage Requirments:
- Pharmacy Support Number 800-722-3476
AZO Bladder Control with Go Less
12/31/2037
Last Updated: 09/12/2023
Healthcare providers may join the AZO Healthcare Professional Network to be notified of samples for select AZO products.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Doctor/Healthcare Provider
- Coverage Requirments:
- Pharmacy Support Number 800-722-3476
Myrbetriq
12/31/2037
Last Updated: 10/12/2023
Healthcare providers may request samples of Myrbetriq for their practice by logging onto the MySampleCloset.com website.
- Prescription
- Offer Type: Free Sample Offer
- Activate By: Doctor/Healthcare Provider
- Coverage Requirments:
- Pharmacy Support Number 800-477-6472
Gemtesa
12/31/2023
Last Updated: 06/30/2023
Gemtesa Simple Savings Card: Eligible commercially insured patients may pay as little as $10 per 30-day supply (maximum savings is $380 for each fill) or $0 per 90-day supply maximum savings is $1140 for each fill); offer valid for up to 12 fills for a 30-day supply or 4 fills for a 90-day supply; for additional information contact the program at 833-876-8268.
- Prescription
- Offer Type: Copay Card Sign-up
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 800-433-4893
Gemtesa
12/31/2023
Last Updated: 06/30/2023
Gemtesa Simple Savings Card: Eligible commercially insured patients/RX not covered may pay $95 per 30-day prescription with a savings of $415 per fill; card is valid for up to 12 prescription fills; for additional information contact the program at 833-876-8268.
- Prescription
- Offer Type: Copay Card Sign-up
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 800-433-4893
Conveen Optima
12/31/2037
Last Updated: 10/16/2023
Order FREE samples of Conveen products; for additional information contact the program at 800-533-0464.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Patient and Doctor
- Coverage Requirments:
- Pharmacy Support Number 800-533-0464
Depend Fresh Protection Underwear for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Fresh Protection Underwear for Women
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Night Defense Underwear for Men
12/31/2037
Last Updated: 09/25/2023
Sign-up to save on any one package of Depend Night Defense Underwear Product (10 ct. or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Night Defense Underwear for Women
12/31/2037
Last Updated: 09/25/2023
Sign-up to save on any one package of Depend Night Defense Underwear Product (10 ct. or larger).
- Over-the-counter
- Offer Type: Sign-up/receive future savings
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Protection Plus Underwear for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Protection Plus Underwear for Women
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Guards for Men
12/31/2037
Last Updated: 09/25/2023
Sign-up to save on one package of Depend Shields or Guards for Men (8 count or larger).
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Shields for Men
12/31/2037
Last Updated: 09/25/2023
Sign-up to save on one package of Depend Shields or Guards for Men (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
AZO Bladder Control with Go Less
12/31/2037
Last Updated: 09/12/2023
Sign-up with an email address to receive special offers on AZO products; sign-up link is found at the bottom of the website.
- Over-the-counter
- Offer Type: Sign-up/receive future savings
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 800-722-3476
Depend Protection with Tabs Unisex Briefs
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Silhouette Underwear Products for Women
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Unisex Night Defense Underpads
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
AZO Bladder Control and Weight Management
12/31/2037
Last Updated: 09/12/2023
Sign-up with an email address to receive special offers on AZO products; sign-up link is found at the bottom of the website.
- Over-the-counter
- Offer Type: Sign-up/receive future savings
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 800-722-3476
Depend Night Defense Underwear for Women
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Depend Night Defense Underwear for Men
12/31/2037
Last Updated: 09/22/2023
Sign-up to save on any one package of Depend Products (8 count or larger).
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-413-3736
Botox
12/31/2037
Last Updated: 05/11/2023
Botox Medicare Part D Extra Help Subsidy: Patients who have Medicare Part D coverage may be eligible to apply for the Part D Extra Help Subsidy and once accepted to the program may receive reduced premiums and lower prescription costs; contact the program directly for questions or to sign-up.
- Prescription
- Offer Type: Copay Card Program
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 800-772-1213
Tranquility Premium Protection Products
12/31/2037
Last Updated: 10/04/2023
Sign-up with an email address for special offers for Tranquility Products; sign-up link is found at the bottom of the website.
- Over-the-counter
- Offer Type: Sign-up/receive future savings
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 866-865-6101
Elmiron
12/31/2037
Last Updated: 07/26/2023
Elmiron Medicare Part D Extra Help Subsidy: Patients who have Medicare Part D coverage may be eligible to apply for the Part D Extra Help Subsidy and once accepted to the program may receive reduced premiums and lower prescription costs; contact the program directly for questions or to sign-up.
- Prescription
- Offer Type: Copay Card Program
- Activate By: Patient
- Coverage Requirments:
- Pharmacy Support Number 800-772-1213
Nocdurna
12/31/2037
Last Updated: 07/20/2023
Healthcare providers may request samples of Nocdurna by filling out a form; completed form may be faxed to 614-652-7117 or emailed to antaressamples@cardinalhealth.com; form can be found at the top right hand side of the webpage.
- Prescription
- Offer Type: Free Sample Offer
- Activate By: Doctor/Healthcare Provider
- Coverage Requirments:
- Pharmacy Support Number 844-735-5950
AZO Bladder Control and Weight Management
12/31/2037
Last Updated: 09/12/2023
Healthcare providers may join the AZO Healthcare Professional Network to be notified of samples for select AZO products.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Doctor/Healthcare Provider
- Coverage Requirments:
- Pharmacy Support Number 800-722-3476
AZO Urinary Pain Relief
12/31/2037
Last Updated: 09/12/2023
Healthcare providers may join the AZO Healthcare Professional Network to be notified of samples for select AZO products.
- Over-the-counter
- Offer Type: Free Sample Offer
- Activate By: Doctor/Healthcare Provider
- Coverage Requirments:
- Pharmacy Support Number 800-722-3476
Poise Impressa Bladder Support Products
12/31/2037
Last Updated: 11/21/2023
Sign-up with an email address to receive coupons for Poise products.
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-947-6473
Poise One 2-in-1 Products
12/31/2037
Last Updated: 11/21/2023
Sign-up with an email address to receive coupons for Poise products.
- Over-the-counter
- Offer Type: Sign-up Coupon
- Activate By: Patient sign form
- Coverage Requirments:
- Pharmacy Support Number 877-947-6473