Did you and the patient receive a physical co-pay card from a healthcare professional? Activate it here or over the phone by calling 1-877-C19-PACK (1-877-219-7225 ).
Enroll in the Co-Pay Savings Program
The program can help patients save on their PAXLOVID prescription. See if they qualify below.
PAXLOVID is authorized for
emergency use
- PAXLOVID has not been approved, but has been authorized for emergency use by FDA under an EUA, for the treatment of mild-to-moderate COVID-19 in pediatric patients 12 years of age and older weighing at least 88 pounds (40 kg) who are at high risk for progression to severe COVID-19, including hospitalization or death.
- The emergency use of PAXLOVID is only authorized for the duration of the declaration that circumstances exist justifying the authorization of the emergency use of drugs and biological products during the COVID-19 pandemic under Section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1), unless the declaration is terminated or authorization revoked sooner.
Patient or their caregiver can complete the enrollment form below to see if they are eligible for the Co-Pay Savings Program and download a co-pay card.
1
Enter the patient's personal information and be sure that it is accurate.
2
If the patient is eligible, download the
3
That’s it! Simply present the card to the pharmacist when picking up the patient’s PAXLOVID prescription.
Please confirm if any of the following statements are true for the patient enrolling:
All fields are required unless otherwise noted.
- They have insurance from any federal healthcare program (including Medicare, Medicaid, TRICARE, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program)
- They receive Social Security Disability Insurance (SSDI) or any other Social Security Administration (SSA) benefit
- They receive insurance from the military
We’re sorry, you are not eligible for the Co-Pay Savings Program.
You or the patient may still qualify for PAXLOVID at no charge,* or for other programs.† Please visit PAXCESSpatientportal.com for more information or reach out to 1-877-C19-PACK
*Other administrative fees may apply.
†With a focus on ensuring access for patients, the U.S. Government Patient Assistance Program (USG PAP) operated by Pfizer will continue to provide patients on Medicare, Medicaid, TRICARE, VA Community Care Network, and those who are uninsured access to PAXLOVID for free through December 31, 2024. PAXLOVID through USG PAP is not available to patients who have commercial prescription drug health insurance. The USG PAP operated by Pfizer is an independent program with separate eligibility requirements offered by the United States Department of Health and Human Services and is not owned by Pfizer. Terms and conditions apply. Full terms and conditions for the USG PAP may be found here.
Pfizer Privacy Statement
Pfizer understands that the patient's personal and health information is private and will only use their information in accordance with our Privacy Policy. The information provided will only be used by Pfizer and parties acting on its behalf to send the caregiver and patient the materials requested as well as other helpful product and/or related product information, disease state information, offers, and services.
All fields are required unless otherwise noted.
