Resources & Support

Coverage & support

CAPLYTA has broad formulary coverage

Commercial Insurance:

  • Unrestricted access on the two largest PBMs – CVS Caremark & Express Scripts National Formulary
  • Covered for over 80% of Commercial Patients
  • Eligible* patients may pay as little as $0 for their first two fills and $15 for subsequent fills with their CAPLYTA Savings Card. Please see eligibility Criteria and Terms & Conditions.

Medicare Part D/Medicaid:

  • Covered for >98% of Patients

Source: Data on File. 2022.

Medicare Part D/low-income subsidy patients9,10

See how the Medicare Extra Help Program can assist Medicare Part D/low-income subsidy patients with prescription costs.

  • 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 $9.20 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

Prior Authorization support

You can visit www.CoverMyMeds.com to initiate the Prior Authorization process for both commercially and government-insured patients. Generally, ~8 out of 10 Prior Authorization submissions for CAPLYTA are approved.

Mon - Fri 8:00am - 11:00pm ET

Sat 8:00am - 6:00pm ET

Pharmacy call back guide

Download a guide to help you and your office staff handle pharmacy rejections so your patients can access CAPLYTA.

Prior Authorization submission information

Download a helpful guide to use when filling out and submitting Prior Authorizations for CAPLYTA for your patients.

*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. Intra-Cellular Therapies, Inc. 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 and Conditions.

Cost & savings

Eligible* patients may pay as little as $0 for their first two fills up to a 30-day supply and $15 for subsequent fills of CAPLYTA up to a 90-day supply.

Download or text 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?

or

Eligible* patients can text "CAPLYTA" to 26789 to receive the Copay eCard on their phones through the CAPLYTA text message program.Download a digital Copay Savings Card to your phone and receive useful text messages about your prescription.Get text messages right to your phone. Get alerts on how much you're saving, refill reminders, and the status of your insurance coverage. Plus, you'll have the option to order refills via text. 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.

Samples

CAPLYTA samples for your patients

Order samples online

Order samples online
or

Or call this toll-free number to order samples or request a representative

Call this toll-free number to order samples or request a representative

Resources

Helpful resources for CAPLYTA

Telemedicine resources

Find resources that may be useful for you and your patients during telemedicine visits

Get resources

Patient brochure

Download a brochure for patients about starting treating with CAPLYTA.

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Intra-Cellular Therapies, Inc. is committed to supporting you and your patients.