Resources & Support
Learn how your patients might be able to save on CAPLYTA
CAPLYTA has broad formulary coverage
- Medicare Part D: CAPLYTA has covered access for over 95% of people on Medicare
- Medicaid: CAPLYTA has covered access for over 95% of those with Fee-for-Service (FFS) State Medicaid
- Commercial Insurance: Most patients with commercial insurance may pay as little as $0 for their first fill and $15 for refills with their CAPLYTA Copay Savings Card. Click here for full Eligibility Criteria and Terms & Conditions.*
Source: Data on file, Intra-Cellular Therapies, Inc. Formulary data provided by Managed Markets Insight and Technology, LLC™, a trademark of MMIT, as of 08/05/2020. Because formularies do change and many health plans offer more than one formulary, please check directly with the health plan to confirm coverage for individual patients.
Savings card for eligible* patients
Two convenient ways to access the savings card:
Download the card and provide it to your eligible* patients.
Are you a licensed prescriber in the state of Vermont?
Eligible* patients can text "CAPLYTA" to 26789 to receive the Copay eCard on their phones through the CAPLYTA text message program. Please see full Terms & Conditions and Eligibility Criteria below.Patients can also sign up for text messages about copay savings and refill reminders. Patients can opt out of this program at any time.
Message & Data Rates may apply. Message frequency varies. Terms & Conditions apply: www.engagedrx.com/CAP. Once enrolled, text HELP for help. Text STOP to end.
*This offer is valid for eligible new or existing patients who are filling a prescription for CAPLYTA. Eligible patients must be at least 18 years old and less than 65 years old, residents of the U.S., excluding Puerto Rico and have a valid prescription for CAPLYTA for a Food & Drug Administration approved indication. This Copay program is valid ONLY for patients with private commercial insurance and NOT valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, TRICARE®, or other federal or state health programs. Offer is not valid for cash paying patients and is only good at participating retail pharmacies. Offer is not transferable, is not insurance, has no cash value, and may not be used in combination with other offers. Void if prohibited by law, taxed, or restricted.
All participants are responsible for reporting the receipt of all Program benefits as required by their insurance provider. No party may seek reimbursement for all or any of the benefit received through this Program. ITCI reserves the right to rescind, revoke or amend the Program without notice at any time. Additional eligibility criteria apply. Click here for full Eligibility Criteria and Terms & Conditions.
By using this copay card, you acknowledge that you currently meet all of the Eligibility Criteria and Terms & Conditions and will comply with the terms and conditions below.
PROGRAM ELIGIBILITY CRITERIA AND TERMS & CONDITIONS:
This offer is valid for eligible new or existing patients who are filling a prescription for CAPLYTA.
Patients must be 18 years of age or older and less than 65 years old, residents of the United States, excluding Puerto Rico, and have a valid prescription for CAPLYTA.
Patients must have private commercial insurance. Offer is not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, TRICARE®, or other federal or state health programs (such as medical assistance programs). This offer is not valid for cash paying patients. This offer is not insurance, has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer.
This copay card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private insurance plan or other private health or pharmacy benefit programs. You must deduct the value of this copay card from any reimbursement request submitted to your private insurance plan, either directly by you or on your behalf. You are responsible for reporting use of the copay card to any private commercial insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the copay card, as may be required. You should not use the copay card if your insurer or health plan prohibits use of manufacturer copay cards.
This copay card cannot be combined with any other savings, free trial, or similar offer for the specified prescription.
This offer is good only at participating retail pharmacies. This card may not be redeemed for cash. Void if prohibited by law, taxed, or restricted. Eligible patients may pay as little as $0 per 30-day supply on the first fill, up to the maximum lifetime benefit based on current list price. On subsequent uses, patients may pay as little as $15, up to the maximum benefit of $600. Program benefit calculated on FDA-approved dosing.
A valid Prescriber ID# is required on the prescription.
Data related to the redemption of this copay card may be collected, analyzed, and shared with Intra-Cellular Therapies for market research and/or other purposes related to assessing the CAPLYTA Copay program.
This program is valid through 04/30/2022.
No other purchase is necessary.
Intra-Cellular Therapies, Inc. reserves the right to rescind, revoke, or amend this offer without notice.
Patients with questions about the CAPLYTA Savings Card should call 1-800-639-4047.
PHARMACISTS: When you apply this offer, you are certifying that you have not submitted a claim for reimbursement under any federal, state, or other governmental programs for this prescription. This offer is not valid for cash paying patients. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the terms and conditions described in the Restrictions section below.
Pharmacist instructions for a patient with an Eligible Third Party: Submit the claim to the primary Third-Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer as a copay-only billing using a valid Other Coverage Code, (e.g., 03 or 08). Eligible patients may pay as little as $0 per 30-day supply on the first use, up to the maximum lifetime benefit based on current list price. On subsequent uses, eligible patients may pay as little as $15, up to the maximum benefit of $600. Reimbursement will be received from Change Healthcare.
For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-433-4893.
Restrictions: This offer is valid in the United States, excluding Puerto Rico. Offer not valid for prescriptions reimbursed under Medicaid, a Medicare drug benefit plan, TRICARE®, or other federal or state health programs (such as medical assistance programs). This offer is not valid for cash paying patients. Cash Discount Cards and other non-insurance plans are not valid as primary under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. By using this offer, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payer of the existence and/or value of this offer. It is illegal to (or offer to) sell, purchase, or trade this offer. Program expires 04/30/2022. This offer is not transferable and is limited to one offer per person. Not valid if reproduced.
Void where prohibited by law. Program managed by ConnectiveRx on behalf of Intra-Cellular Therapies, Inc.
Intra-Cellular Therapies, Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time.
Get telemedicine resources
During a time when virtual visits are becoming increasingly popular, these resources may be of useful value to you and your patients:
- Pre-appointment conversation starter
- Order samples online for your patients
- Request for medical information
Download a brochure for patients about
starting treatment with CAPLYTA.
Medicare Part D/low-income subsidy patients9,10
Your Medicare Part D patients with a low-income subsidy (LIS) may be able to receive help with prescription costs through Medicare. This government program is also known as Extra Help.
- Medicare Part D patients are automatically enrolled in Extra Help if they are:
- Dual eligible: receive both Medicare and Medicaid, or are older than 65 years and on Medicaid
- Receiving Supplemental Security Income
- Members of a Medicare Savings Program
- Patients who are enrolled in Extra Help pay a maximum of $8.95 for brand name prescriptions.11
- Medicare beneficiaries receiving LIS get assistance in paying for their Part D monthly premium, annual deductible, coinsurance, and copayments. Also, individuals enrolled in the Extra Help program do not have a gap in prescription drug coverage, also known as the coverage gap, or the Medicare “donut hole”9
Intra-Cellular Therapies, Inc. is committed to supporting you and your patients.