Call 1-855-727-6274 or Fax 1-844-727-6274

THIS SECTION IS FOR PATIENTS ONLY

You can begin the application process by applying via the OPAF Care Connect Patient Portal. The OPAF team will work with your healthcare professional [HCP] to finish the application process. Please follow the instructions below to begin this process.

OPAF Care Connect Patient Portal

If you’re a patient, you can use the OPAF Care Connect Patient Portal to submit and track applications, download forms, upload required documents, and more. Plus, the portal offers the fastest patient application processing time — you’ll receive your eligibility determination within 48 hours once all documentation has been submitted. If you do not have access to the portal, you can download the paper application below.

people-connect

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.

OPAF Care Connect Benefits

Patients Can Apply Online

Submit and manage your OPAF application from
start to finish:

HCPs icon

Receive eligibility determination
within 2 business days

Work icon

Use your work space to find your
application and more

Patients icon

View your application online

Find documents
quickly
and easily

Access your relevant documentation and treatment information in a secure, online location:

  • Search for patient information quickly with My Case Search
  • Initiate annual applications from existing patient case information
  • Store patient eConsent forms for future assistance applications

Get up-to-date and
timely notifications

Stay informed with email notifications for patient applications and product requests:

  • Get updates regarding your application status and determination results
  • Receive notifications when it’s time for annual re-enrollment
  • Track status of product shipments
Register now image

Register today

Prefer to fax in an application for your patient? Just follow these 3 simple steps:

  1. Download and print the application
  2. Collect all required documentation from your patient
  3. Fax the application and the documentation to OPAF at 1-844-727-6274

Please note: Faxed applications are processed within 5 business days. If this is a time-sensitive request, please submit an application online.

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.

Have any questions?

To help expedite your patient’s application, be sure to include the proper documentation with your fax, including:

  1. Proof of income
  2. Proof of US Address

Have any questions?

SEND A SECURE MESSAGE

Supported Medications

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

Abilify Maintena logo
Abilify Asimtufii logo
nuedexta logo
jynarque logo
rexulti logo
samsca logo

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

Welcome to the Otsuka Patient Assistance Foundation, Inc.