This offer may not be redeemed on prescriptions written for longer than 30 days Patient is responsible for applicable taxes, if any. Present your activated Free Trial Offer Card to your pharmacist along with yourĮligible patients who present a Free 30-Day Trial card together with a valid 30-day prescription for ELIQUIS at participating pharmacies can receive a free 30-day supply (up to 74 tablets) of ELIQUIS. The Co-pay Card will be accepted only at participating pharmacies. For those customers using mail-order or any non-participating retail pharmacy, please call tap to call 86 to request a patient rebate form, or go to to download a formīy using this card, you and your pharmacist understand and agree to comply with the eligibility requirements and terms of use Patient is responsible for applicable taxes, if any Present your activated Co-pay Card to your pharmacist, along with your ELIQUIS prescriptionĮligible patients who present an activated Co-pay Card together with a valid prescription for ELIQUIS at participating pharmacies may pay as little as $10 per 30-day supply (up to 74 tablets for the first fill, and up to 60 tablets for all subsequent fills) for up to 24 months, subject to a maximum annual benefit of $6,400.
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