01. Edit your xarelto coupon for 12 months free online
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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!
CVS Caremark may receive rebates, discounts and service fees from pharmaceutical manufacturers for certain listed products. This document contains references toRead more
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