PATIENTS/PRESCRIBERS – For questions please call 1-800-471-9298
PHARMACISTS – Please call OPUS Health at 1-800-364-4767 with any questions

CLOZARIL Copay Program

Program Rules

If eligible, you pay as little as $0 per script.*

*The program will cover patient copay, or coinsurance, responsibility up to a maximum benefit, on any filled prescription for Clozaril (clozapine). Not valid for patients enrolled in Medicare or Medicaid. Other restrictions apply.

Program Eligibility

You may be eligible if you:

Patient Eligibility Questions

We need to determine your eligibility. Please answer all questions below.

Is the patient who will use this coupon 18 years of age, or older?

Yes
No

Is the patient who will use this coupon a resident of the United States?

Yes
No

Do you confirm that the patient using this coupon will not seek reimbursement for their medication costs from any other program such as those listed below?

  • Pharmaceutical patient assistance foundations
  • A Flexible Spending Account (FSA)
  • A Health Savings Account (HSA)
  • A Health Reimbursement Account (HRA)
Yes
No

Do you confirm that the patient using this coupon is covered under a commercial or private insurance plan, and is not eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare, (including Medicare Advantage and Part A, B and D Plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state healthcare programs?

Yes
No

Is the patient who will be using this coupon currently being treated with Clozaril?

Yes
No

Please see full Prescribing Information, including Important WARNING.

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