Abilify

Otsuka Patient Assistance Foundation Patient Guide: How to Get Abilify at Low or No Cost

About This Program

The Otsuka Patient Assistance Foundation (OPAF) provides no-cost or low-cost Abilify (aripiprazole) to eligible patients who are uninsured or underinsured and have limited financial resources. This program ensures that cost is not a barrier to accessing this important medication.

About Abilify (Aripiprazole)

Abilify is an antipsychotic medication used to treat schizophrenia, bipolar disorder, major depressive disorder, and other conditions. It works by helping to restore the balance of certain natural substances in the brain. Your healthcare provider has determined that Abilify is an appropriate treatment for your condition.

Who Qualifies for OPAF Assistance

You may be eligible for the Otsuka Patient Assistance Foundation program if you meet these criteria:

• You are a U.S. resident
• You are uninsured or underinsured (have insurance that does not adequately cover Abilify)
• You have limited household income (specific thresholds vary; contact OPAF for details)
• You have a valid prescription for Abilify from a licensed healthcare provider

The program is designed to help patients regardless of specific income thresholds, focusing on those with genuine financial need.

Income Eligibility

While OPAF does not publish strict income cutoffs, the program prioritizes patients with low household income who cannot afford their medication. Income eligibility is evaluated on a case-by-case basis and considers:

• Total household gross income
• Number of household members
• Current financial obligations

To determine if you qualify, you'll need to provide proof of your household income when you apply.

Insurance Requirements

You must be either:

• Uninsured (have no health insurance coverage), or
• Underinsured (have insurance that does not adequately cover Abilify, such as high copays, deductibles, or denials)

If you have Medicare, Medicaid, or other government insurance, you may still qualify if your coverage does not adequately pay for Abilify. Contact OPAF to discuss your specific situation.

Required Documents

When you apply, you'll need to provide:

Proof of Income (choose ONE):

• Federal income tax return (Form 1040 or similar)
• W-2 from the previous tax year
• 1099-MISC form
• Two most recent paystubs
• Social Security award letter
• Disability income information
• Unemployment benefits letter
• Letter from employer on company letterhead

Proof of Residency (choose ONE):

• Social Security number
• State driver's license
• U.S. birth certificate
• Utility bill or lease agreement

Prescription:

• A valid prescription for Abilify from your healthcare provider (required in all states; NY, NJ, and IA have additional state-specific requirements)

How to Apply: Step-by-Step

Step 1: Gather Your Documents

Collect one proof of income document and one proof of residency document as listed above. Have your prescription ready.

Step 2: Choose Your Application Method

You have three options:

Option 1: Apply Online (Fastest)

• Visit www.otsukapatientassistance.com
• Access the OPAF Care Connect portal
• Complete the application form with all requested information
• Upload your documents
• Submit your application

Option 2: Apply by Fax

• Download the application form from www.otsukapatientassistance.com/patient-forms
• Complete all sections of the form
• Attach copies of your proof of income and proof of residency
• Fax to: 1-844-727-6274

Option 3: Apply by Mail

• Download and complete the application form
• Attach copies of required documents
• Mail to: Otsuka Patient Assistance Foundation, Inc. PO Box 4530 Chesterfield, MO 63006

Step 3: Complete the Application Accurately

When filling out your application, include:

• Your full name, address, date of birth, and contact information
• Your insurance information (or confirmation that you are uninsured)
• Your household income information
• Your healthcare provider's information
• Your prescription details

Important: Complete all sections accurately to avoid processing delays. Incomplete applications will take longer to process.

Step 4: Submit and Wait for Approval

Once you submit your application with all required documents, OPAF will review your eligibility.

Timeline and Delivery

Processing Time:

• Online applications: Eligibility determination may take up to 3 business days upon receipt of the complete application
• Paper applications (fax or mail): Up to 3 business days upon receipt of the complete application and all documentation
• Most completed applications are processed within 2 business days

Incomplete applications may experience significant delays.

Delivery:

• Once approved, Abilify will be shipped directly to you or your healthcare provider's office
• You will receive a notice in the mail with your eligibility determination

What If Your Application Is Denied?

If you do not qualify for the program, OPAF will notify you in writing with the reason. You may:

• Reapply if your circumstances change (such as income reduction or insurance changes)
• Contact OPAF to discuss your situation: 1-855-727-6274 (Monday-Friday, 8 AM-8 PM ET)
• Ask your healthcare provider about other assistance options or generic alternatives
• Contact pharmaceutical patient assistance programs for other medications

Reauthorization

Your assistance through OPAF may require periodic reauthorization. OPAF will notify you when reauthorization is needed. You may need to resubmit proof of income and other documentation to continue receiving assistance.

Need Help?

Contact OPAF:

• Phone: 1-855-727-6274
• Hours: Monday-Friday, 8 AM-8 PM ET
• Website: www.otsukapatientassistance.com
• For adverse reactions: 1-800-438-9927 or FDA MedWatch at 1-800-FDA-1088

Important Disclaimer

This guide provides general information about the Otsuka Patient Assistance Foundation program. Program details, eligibility requirements, and application procedures are subject to change. For the most current and accurate information, visit www.otsukapatientassistance.com or contact OPAF directly. This guide is not a guarantee of eligibility or assistance. Each application is reviewed individually based on current program guidelines and eligibility criteria.