Banner Copay

The Everolimus Tablets for Oral Suspension (Everolimus TFOS) Savings Program

Commercially insured patients
may pay as little as $0
per prescription.*

*Additional Terms and Conditions may apply, see eligibility requirements below.

  • Eligibility
    Questions
  • Savings
    Card

Patient Eligibility*

Please answer the following questions to find out if you are eligible for the Everolimus TFOS Savings card. In order to receive benefits under the program, it is important that you provide accurate information.

Please select Yes or No.
Please select Yes or No.
Please select Yes or No.
*Please note answers to all questions are required.

  • Eligibility
    Questions
  • Savings
    Card
Your virtual Savings Card can be seen below. Please record or print the following information and provide it to your pharmacy for financial assistance.
Copay Card
BIN#
PCN#
GRP#
ID#
Your Savings Card has been activated.
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