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How to use or fill out xarelto rebate form with our platform
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Click ‘Get Form’ to open the XARELTO® rebate form in the editor.
Begin by enrolling in the Janssen CarePath Savings Program if you haven't already. You can activate your card by calling 888-XARELTO or visiting Xarelto.com.
Fill in your personal information, including your name, gender, date of birth, address, email, state, zip code, and phone number. Ensure all required fields marked with an asterisk are completed.
Enter your 11-digit Savings Program ID number found on the front of your card.
Sign and date the form to confirm that you have completed the enrollment and activation process.
Attach a copy of your pharmacy receipt that includes your name, medication details, date, and amount paid for XARELTO®.
Mail the signed form along with the pharmacy receipt to the address provided on the next page.
Start using our platform today to easily complete your XARELTO® rebate form for free!
Patient assistance from Janssen is available if you have commercial, employer-sponsored, or government coverage that does not fully meet your needs. You may be eligible to receive XARELTO free of charge for up to one year. You must meet the eligibility and income requirements for the patient assistance program.
How do I get free samples of Xarelto?
XARELTO withMe Trial Offer Eligible patients receive a free 30-day trial supply of XARELTO with a valid signed 30-day prescription for any XARELTO dose other than 10-mg tablet or 1 mg/mL oral suspension. The XARELTO withMe Trial Offer can be used with the XARELTO Starter Pack.
How do seniors pay for Xarelto?
With commercial insurance, you may pay only $10 for each 30-90 day prescription. With government insurance like Medicare, you may pay about $89 a month for a 30-day supply or $250 for a 90-day supply. You can also check which Advantage and Part D plans in your area cover Xarelto by using Medicares plan finder tool.
What is the Xarelto rebate program?
XARELTO withMe Savings Card. Eligible commercially insured patients may pay as little as $10* for up to a 90-day supply of XARELTO *There is a limit to savings per fill. Maximum program benefit per calendar year shall apply. Offer subject to change or end without notice.
How to get Xarelto at a discount?
The manufacturers of these drugs Pradaxa, Xarelto and have been wooing physicians in part by paying for meals, promotional speeches, consulting gigs and educational gifts.
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This includes plans from the Health Insurance Marketplace. The XARELTO withMe Savings Card is not for people who use any state or federal government-funded healthcare program. Examples of these programs are Medicare, Medicaid, TRICARE, Department of Defense, and Veterans Administration.
xarelto rebate form
340B Rebate Model Pilot Program
Aug 14, 2025 This Pilot Program is open to a selected group of drugs and for manufacturers that submit plans meeting specific criteria. The Pilot Program
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