ORILISSA SAVINGS CARD


With the ORILISSA Savings Card, you could pay as little as $5* a month for ORILISSA.

*Eligibility restrictions apply.
Click here to view them in full.

Whether you’re first starting ORILISSA or have been taking it for some time, you may be able to save on your prescription. If eligible, you could pay as little as $5* a month with the ORILISSA Savings Card.

The ORILISSA Savings Card is currently not available to patients whose prescriptions are paid for by any federal, state, or government-funded insurance program (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs, or for those without insurance. However, other options may be available. Call us to understand your options).

If you’ve paid out of pocket for ORILISSA and need to request reimbursement, go to OrilissaRebate.

Ready to get started?

Select one of the options below.
You can also call us at 1-844-OriForMe (1-844-674-3676).

 

This process is quick if your info is already in our system. So let’s check that first.

(All fields are required unless specially noted.)

Great! It looks like you’ve already signed up.

What kind of prescription insurance do you have?

Your insurance information will be used to determine your eligibility for the ORILISSA Savings Card.

(All fields are required unless specially noted.)

For example, Medicare (including Part D), Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs
Co-Pay Card

 

 

 

Congratulations! You qualify for the ORILISSA Savings Card!

Your card has been activated. Download your card here or check your email for your savings card.

Then, make sure that your pharmacy has both your ORILISSA prescription and your savings card information.

We've issued you a new ORILISSA Savings Card.

We didn't recognize the card numbers you entered, so we couldn't activate your current card, but don't worry! We've simply gone ahead and issued you a new one. It's already activated and ready to use. Just download it below and discard your current card.

You'll also receive an email with a link to your savings card, so keep an eye on your inbox.

Congratulations! You're all set!

Your card has been activated! Download your card here or check your email for your savings card.

Then, make sure that your pharmacy has both your ORILISSA prescription and your savings card information.



*Available to patients with commercial prescription insurance coverage for ORILISSA™ (elagolix) who meet eligibility criteria. Copay assistance program is not available to patients receiving prescription reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving prescription drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the ORILISSA Savings Card and patient must call Ori for Me™ at 1-844-OriForMe (1-844-674-3676) to stop participation. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from Ori for Me from any third-party payers. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums (maximum benefit of $200), may apply. This is not health insurance. Please see full Terms and Conditions.