Renew Your Co-Pay Savings Card

You can continue saving on XELJANZ by renewing your Co-Pay Savings Card with one simple step. Please complete the form below, so you can receive your new card.

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All fields are required unless marked optional.

Are you currently taking:

Member ID Number

Where do I find my Member ID Number?

Your 10-digit Member ID number can be found on the XELJANZ emails you’ve received from Pfizer or by calling 1-844-935-5269.

PLEASE VERIFY THE FOLLOWING INFORMATION TO RECEIVE A CO-PAY SAVINGS CARD.

  • I am 18 years or older.
  • I currently live in the United States or its territories.
  • I do not purchase my prescription medication through a federal or state prescription drug program such as Medicare or Medicaid.
  • I agree with the limits, terms, and conditions that apply.

Only current, commercially insured XELJANZ and XELJANZ XR patients are eligible for the Co-Pay Savings Card. If you’re thinking about a new chapter in your treatment plan, our support program has tips and resources to help you and your doctor decide.