If your Medicare prescription drug insurance does not cover SUTAB® or if your out-of-pocket costs exceed $50* for your Medicare Part D prescription of SUTAB ® , Braintree Laboratories, Inc. may be able to help.

With this program, you no longer seek reimbursement for your SUTAB ® prescription through your Medicare provider for out-of-pocket costs. Instead, you can use this Medicare Part D Alternative Savings Program. This program has no impact on your current insurance plan. Your Medicare Part D plan remains the same. To sign up for this savings program, just follow the 3 steps shown on the instructions that will be included with your card. If you have questions related to this program or need assistance activating the card, please call 844-721-1400.

*Terms, conditions, and limitations apply. Most eligible patients will pay as little as $50. Terms and Conditions below.

Please complete all fields and confirm your agreement with the statements below to download your card.

Already have a card? Click here to activate it and save.

All fields are required.

PATIENT TERMS AND CONDITIONS

If you have questions related to this program, please call 844-721-1400.