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Lupron Depot Co-pay Savings Card
Lupron Depot is one of the most commonly prescribed fertility medications, and also one of the most expensive out of pocket. If you are a cash-paying patient, or if your commercial insurance covers Lupron Depot but the co-pay is higher than you expected, there is a manufacturer rebate program that can put up to $300 back in your pocket every month.
This page covers everything you need to know: who qualifies, what the program covers, and exactly how to enroll through Prima.
"Up to $300 back per month on Lupron Depot, for patients who qualify. Here is how to claim it."
The short version
What the program offers
$300
maximum rebate per month
Cash-pay patients
$300
maximum co-pay reimbursement per month
Insured patients
1,2
weeks to receive your rebate check by mail
After submission
Eligible medications
What the rebate covers
The rebate program applies to one medication specifically.
Covered medication
- Lupron Depot (leuprolide acetate for depot suspension) 3.75mg
Eligibility
Who qualifies for the rebate
There are two eligible patient groups. Read both carefully before enrolling, as the enrollment steps differ depending on your insurance situation.
You are eligible if
- You are a cash-paying patient with commercial insurance but no coverage for Lupron Depot
- You have commercial insurance coverage for Lupron Depot but are unable to use the Lupron Depot Co-pay Savings Card for your co-pay
You are not eligible if
- You receive prescription reimbursement under any federal, state, or government-funded insurance plan, including Medicare or Medicaid
- Your indication is endometriosis or anemia prior to uterine fibroid surgery
How to enroll
Step-by-step enrollment
The process takes about 10 minutes. Here is exactly what to do.
1
Go to the savings card website
Visit www.luprondepotsavingscard.com to begin your enrollment.
2
Answer the eligibility questions
Select your indication and confirm whether or not you have commercial insurance coverage. Your answers determine which program you qualify for.
3
Download the savings card
Download the card and note the RxGrp and RxID numbers printed on the front. You will need both of these when completing the rebate form.
4
Download and complete the rebate form
Fill out the rebate form in full. Have your Prima pharmacy receipt and your insurance card ready to attach as copies.
5
Submit your completed form
Mail your rebate form, or email it to claim.support@iqvia.com, or fax to (908) 548-0968. Include copies of your Prima pharmacy receipt and your insurance card.
6
Receive your rebate check
Your rebate check arrives by mail in approximately 1 to 2 weeks after your submission is processed.
Common questions
What patients ask us most
Can I use the rebate and the co-pay savings card at the same time?
Understanding how the two programs work together
No. The rebate program is specifically for patients who are either cash-paying with no Lupron Depot coverage, or insured patients who cannot use the Co-pay Savings Card. If you can use the Co-pay Savings Card, that is the faster option since savings are applied at the point of sale rather than as a reimbursement after the fact. See our Co-pay Savings Card page to check which program fits your situation.
Do I need to re-enroll every month?
How often you submit
You submit a new rebate form each month with your updated Prima pharmacy receipt. The eligibility card from step 3 can be reused, but the claim itself needs to be submitted for each monthly fill. Keep copies of your receipts and insurance card so the process is quick each time.
What Prima receipt do I need?
What to attach to your form
Your Prima pharmacy receipt showing the dispensed medication, the date, and the amount you paid. If you need a copy of a past receipt, contact Prima at (718) 230-3535 and we will send it to you.
I have Medicare or Medicaid. Is there any savings option for me?
Federal insurance and manufacturer programs
Unfortunately, manufacturer rebate and co-pay programs are not available to patients on federal or state government insurance plans, including Medicare, Medicaid, or any government-funded plan. If cost is a concern, call Prima at (718) 230-3535. We can review your specific situation and identify any other savings options that may apply, including patient assistance programs offered by the manufacturer directly.
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Program Note
The Lupron Depot rebate program is a manufacturer-sponsored patient savings program administered by IQVIA. Terms and eligibility requirements are subject to change. Prima Pharmacy facilitates access to this program on behalf of eligible patients but is not the program administrator. Contact Prima at (718) 230-3535 with any questions about your specific eligibility.
