Check
eligibility
for
patients

This interactive tool helps patients, caregivers, and healthcare professionals determine no-cost medication eligibility from the Otsuka Patient Assistance Foundation, Inc. (OPAF).

Your information will not be stored.

Please answer all of the following questions:

Medication

Insurance

Household

Income

We've detected that you're currently located outside of the United States/Puerto Rico.

Assistance from the Otsuka Patient Assistance Foundation, Inc. (OPAF) is available only to residents of the US/Puerto Rico.

If you're in the US/Puerto Rico, or are checking on behalf of a resident of the US/Puerto Rico, you can start the eligibility verification process.

Medication

Select the medication:

A prescription hasn't been written yet

The medication is not listed

See U.S. FULL PRESCRIBING INFORMATION for NUEDEXTA.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for
ABILIFY MAINTENA, ABILIFY ASIMTUFII, JYNARQUE, REXULTI, and SAMSCA.
See MEDICATION GUIDES for ABILIFY MAINTENA, ABILIFY ASIMTUFII, JYNARQUE, REXULTI, and SAMSCA.

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Insurance

Select the type of insurance coverage

Commercial Insurance

(Employer or Healthcare Marketplace)

Government Insurance

(Medicare, Medicaid, VA Benefits, or TRICARE)

No Insurance

Will insurance cover this medication?

Yes, coverage has been approved

No, coverage has been denied

I'm unsure of the coverage

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Household

Please, enter the number in a range 1 - 20

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Income

You can’t submit without a number

Per Year

Per Month

Per Week

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You may not be eligible for assistance

We encourage you to call our Dedicated Patient Access Advocates to discuss your eligibility. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

You may not be eligible for assistance

We encourage you to call our Dedicated Patient Access Advocates to discuss your eligibility. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

You may not be eligible for assistance

We encourage you to call our Dedicated Patient Access Advocates to discuss your eligibility. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

You may not be eligible for assistance

We encourage you to call our Dedicated Patient Access Advocates to discuss your eligibility. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

You may be eligible for assistance

Here are the next steps:

If you are a patient that has been prescribed an Otsuka medication you may start an application online via the OPAF Care Connect Patient Portal.

If you are a HealthCare professional (HCP) that has a patient prescribed an Otsuka medication you may start an application online via the OPAF Care Connect Prescriber Portal.

If you’d prefer to use a paper application, you can download the application.

To help expedite the application process, please be sure to provide your HCP the required documentation.

If you have any questions, please call our Dedicated Patient Access Advocates. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

You may be eligible for assistance

Here are the next steps:

If you are a patient that has been prescribed an Otsuka medication you may start an application online via the OPAF Care Connect Patient Portal.

If you are a HealthCare professional (HCP) that has a patient prescribed an Otsuka medication you may start an application online via the OPAF Care Connect Prescriber Portal.

If you’d prefer to use a paper application, you can download the application.

To help expedite the application process, please be sure to provide your HCP the required documentation.

You may download an application at OPAF | Patient Forms and together with your healthcare professional (HCP) fill and submit an application for assistance.

To help expedite the application process, please be sure to provide your HCP the required documentation.

If you have any questions, please call our Dedicated Patient Access Advocates. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

You may be eligible for assistance

Here are the next steps:

You may download an application at OPAF | Patient Forms and together with your healthcare professional (HCP) fill and submit an application for assistance.

To help expedite the application process, please be sure to provide your HCP the required documentation.

If you have any questions, please call our Dedicated Patient Access Advocates. They can be reached at 1-855-727-6274, Monday-Friday, 8 AM-8 PM (ET).

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If you have any questions about OPAF, eligibility, or the documentation that’s required, please visit our FAQ section.

Supported Medications

OPAF provides eligible patients no-cost support for the following prescribed medications:

See U.S. FULL PRESCRIBING INFORMATION for NUEDEXTA.
See U.S. FULL PRESCRIBING INFORMATION, including BOXED WARNING for ABILIFY MAINTENA, ABILIFY ASIMTUFII, JYNARQUE, REXULTI, and SAMSCA.
See MEDICATION GUIDES for ABILIFY MAINTENA, ABILIFY ASIMTUFII, JYNARQUE, REXULTI, and SAMSCA.

To report SUSPECTED ADVERSE REACTIONS, contact Otsuka America Pharmaceutical, Inc. at
1-800-438-9927 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Otsuka America Pharmaceutical, Inc. does not control or influence how Otsuka Patient Assistance Foundation, Inc. distributes funds.

Secure messaging ensures patient privacy because it is a HIPAA-compliant, password-protected electronic messaging platform. You can communicate directly with an OPAF Patient Access Advocate without having to pick up the phone. Through the platform you can securely send electronic messages with any questions, communications, and documents at your convenience.

Because it is HIPAA-compliant, there is a one-time account activation process. The activation process takes less than 3 minutes. Once your account is active, you can send messages to OPAF immediately.

To setup your OPAF secure message account follow the steps below:

Click on the (button or envelope) below to start the process
The system will prompt you to enter your email address as a "New to SecureContact"
A verification email will be sent to the email address that you entered
In your email inbox, you will find a message from "[email protected]"
Open this message and click on the link to activate your account
Complete the account activation by creating a password
Your account is active, and you can securely send a message to OPAF

If you have any questions, please contact OPAF at 1-855-727-6274 8:00 AM - 8:00 PM ET.

MESSAGE US

message

When you submit an application, please include proof of income
for all members of the household who file a tax return.

Acceptable documentation includes one of the following:

Federal Income Tax Return (1040, etc.)
W-2 from previous tax year
1099-MISC form
Two most recent paystubs
Social Security award letter

Disability income information
Unemployment benefits letter
Letter from employer on company letterhead
Income attestation letter from healthcare prescriber

Eligibility is not determined by U.S. citizenship. However, a U.S. home address is required. Acceptable documentation includes one of the following:

Mortgage statement or rental agreement
Two (2) utility bills
State driver’s license or State ID with current home address information

U.S. address attestation letter from healthcare prescriber

OPAF performs a benefit verification for insured patients. If the benefit verification is insufficient, OPAF may require additional denial documentation such as:

Explanation of benefits
Insurance statement
Prior authorization denial letter

Check eligibility for patients

Please answer all of the following questions:

We've detected that you're currently located outside of the United States/Puerto Rico.

Medication

Insurance

Household

Income

You may not be eligible for assistance

You may not be eligible for assistance

You may not be eligible for assistance

You may not be eligible for assistance

You may be eligible for assistance

Here are the next steps:

You may be eligible for assistance

Here are the next steps:

You may be eligible for assistance

Here are the next steps:

Supported Medications

Secure Messaging

When you submit an application, please include proof of income for all members of the household who file a tax return.

Welcome to the Otsuka Patient Assistance Foundation, Inc.

Welcome to the Otsuka Patient Assistance Foundation, Inc.

Check
eligibility
for
patients

When you submit an application, please include proof of income
for all members of the household who file a tax return.