Check Eligibility
& Apply
Check Eligibility & Apply

Check Eligibility
& Apply
Check Eligibility & Apply

ELIGIBILITY RESULTS

This tool will help you determine if you’re eligible to receive medication from the Otsuka Patient Assistance Foundation (OPAF) at no cost.

This tool will help to determine eligibility to receive medication from the Otsuka Patient Assistance Foundation (OPAF) at no cost.

Answer a few questions below about your current medication, your insurance coverage, and your household income to determine your eligibility.

Only available to residents of the United States and Puerto Rico.

We’ve detected that you’re currently located outside of the United States.

Assistance from OPAF is only available to residents of the United States and Puerto Rico.

If you are in the US, or are checking on behalf of a US resident, click below to get started.

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Medication
Insurance
Income
Result

Choose Your
Current Prescription

All questions are required.
Your information will not be stored.

Next Steps

Abilify_Logo
Abilify_Maintena_Logo
JYNARQUE_Logo
Rexulti_Logo
Samsca_Logo
I don’t have a prescription
My medication is not listed

If you’re eligible, complete this application with your doctor and submit it to OPAF through mail or fax.

Submit Via Mail
Otsuka Patient Assistance Foundation, Inc.
PO BOX 220248
Charlotte, NC 28222-0248

Submit Via Fax
1-844-727-6274

Download Application

If you’re eligible, talk to your doctor about your results so they can complete an application for your OPAF assistance. You will be required to provide eConsent while in your doctor’s office, or through an emailed link, and you may need to provide additional information so your doctor can complete your application. Call our Dedicated Patient Case Coordinators at 1-855-727-6274 Monday-Friday between 8 AM-8 PM ET if you have any questions.

Your doctor must complete a few sections of your application. You can complete your sections of the application first or fill out the application with your doctor’s assistance. When the form is complete, mail or fax it to Otsuka Patient Assistance Foundation, Inc. (OPAF). See mail or fax details.

Your doctor will track the status of your application and notify you about your results. If you are accepted for OPAF assistance, your doctor will need to apply on your behalf each year to continue with support. If you aren’t accepted for OPAF assistance, you can check eligibility and try again at a different time. Call our Dedicated Patient Case Coordinators at 1-855-727-6274 Monday-Friday between 8 AM-8 PM ET if you have any questions.

Patients treated wth Otsuka Medications ABILIFY® (aripiprazole) Tablets, ABILIFY MAINTENA® (aripiprazole), REXULTI® (brexpiprazole), or SAMSCA® (tolvaptan) may be eligible for other coverage assistance, appointment and refill reminders, and additional patient support offerings.

Visit Otsuka-US.com

Whether or not you’re being treated with Otsuka medications, you can explore other assistance programs by visiting:

RxAssist.org
NeedyMeds.org
PPA Rx
MedData

If you’re a health care provider who is interested in streamlining the patient medication assistance process in your practice visit:
MD Cares

Patients treated wth Otsuka Medications ABILIFY® (aripiprazole) Tablets, ABILIFY MAINTENA® (aripiprazole), JYNARQUE™ (tolvaptan), REXULTI® (brexpiprazole), or SAMSCA® (tolvaptan) may be eligible for other coverage assistance, appointment and refill reminders, and additional patient support offerings.

Visit Otsuka-US.com

Whether or not you’re being treated with Otsuka medications, you can explore other assistance programs by visiting:

RxAssist.org RxAssist
NeedyMeds.org NeedyMeds
PPA Rx
MedData

If you’re a health care provider who is interested in streamlining the patient medication assistance process in your practice visit:
OPAF Care Connect
MD Cares

Find answers to common questions on our Frequently Asked Questions (FAQs) page.

See FAQs

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