Please see full Prescribing Information including Medication Guide, or visit Velsipity.com.
Please see full Prescribing Information for Xeljanz, including BOXED WARNING and Medication Guide, or visit Xeljanz.com.
To submit a rebate claim you will need:
- A Pfizer I&I Co-Pay Patient Portal account (create account)
- Your insurance information
- Information to verify your drug purchase
- Your co-pay card information
Please note: You may only submit a claim if you have commercial insurance or are self-insured, and you are not a participant of any Federal Healthcare Program (including Medicare, Medicaid, Tricare, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program).
When submitting a rebate claim using this portal, a completed rebate form does not need to be uploaded.
Instructions for submitting your claim through mail or fax can be found on the Contact Us page.