Xarelto

Indicated For

Atrial Fibrillation (AF), Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), Peripheral Artery Disease (PAD), Coronary Artery Disease (CAD)

About This Medication

# Johnson & Johnson Patient Assistance Foundation Patient Guide: How to Get Xarelto at Low or No Cost ## About This Program The Johnson & Johnson Patient Assistance Foundation (JJPAF) offers free or low-cost Xarelto (rivaroxaban) to eligible patients who cannot afford their medication. Xarelto is a blood thinner prescribed to reduce the risk of stroke and blood clots in patients with certain conditions. If you're struggling to pay for this essential medication, this program may help you access it at no cost. ## Who Qualifies for Xarelto Assistance To be eligible for the Johnson & Johnson Patient Assistance Program, you must meet ALL of the following requirements[3]: - **Live in the United States or a U.S. territory** - **Be treated as an outpatient by a U.S.-licensed healthcare provider** - **Have a valid prescription for Xarelto from your doctor** - **Meet income eligibility requirements** (see Income Eligibility section below) - **Have no insurance or inadequate prescription drug coverage** - **For Medicare Part D patients only:** Spend more than 4% of your gross annual household income on prescription drugs and not be eligible for the Low-Income Subsidy (LIS)[3] ## Income Eligibility Requirements Your household income must fall below certain thresholds to qualify. These thresholds vary based on your family size and are typically set at or below 150% of the Federal Poverty Level (FPL) for patients with very limited income[3]. The exact income limits depend on your specific situation and the number of people in your household. | Family Size | Income Consideration | |---|---| | 1 person | Individual income threshold | | 2 people | Couple/household income threshold | | 3+ people | Family size-based threshold | To determine your exact eligibility, contact the program directly at **(833) 742-0791** (Monday–Friday, 8:00 AM–8:00 PM ET)[2][3]. ## Insurance Requirements You generally must be **uninsured or underinsured** to qualify[3]. However, if you have Medicare Part D coverage, you may still be eligible if[3]: - You are not eligible for the Low-Income Subsidy (LIS) - You spend more than 4% of your gross annual household income on prescription drugs - You can provide proof of your out-of-pocket costs If you have private insurance that covers Xarelto, you typically will not qualify unless your out-of-pocket costs are extremely high. ## How to Apply: Step-by-Step ### Step 1: Gather Required Documents Before starting your application, collect the following[2]: - **Proof of income:** A copy of your most recent 1040 or 1040-SR Federal tax return - **Insurance information:** Copies of the front and back of all insurance cards (medical, pharmacy, etc.) - **For Medicare Part D patients:** A pharmacy report or Explanation of Benefits (EOB) statement showing your current-year out-of-pocket costs - **Healthcare provider information:** Your doctor's name, address, and contact details - **Prescription information:** Details about your Xarelto prescription ### Step 2: Complete the Patient Assistance Enrollment Form Download the **Patient Assistance Enrollment Form** from the program website or request it by phone[2]. Complete all sections carefully, including: - Your personal and household information - Financial details (income and household size) - Insurance information - Prescription details - Your signature on page 2, certifying you have read and agree to the Terms of Participation and Terms & Conditions[2] ### Step 3: Have Your Healthcare Provider Complete Their Section Give your doctor a copy of page 3 of the enrollment form. Your healthcare provider must[2]: - Complete all required fields - Sign and date the form - Provide prescription details for Xarelto - Submit their own copy if you're applying for multiple medications ### Step 4: Submit Your Application You have two options for submission[2][3]: **Option A: Online Enrollment** - Visit the program portal at **JanssenPatientAssistance.com/PA** or **JJPatientAssistance.com** - Upload your completed form and supporting documents **Option B: Fax Enrollment** - Fax your completed form and all supporting documents to **(833) 512-0497**[2] ### Step 5: Await Approval and Delivery The program will review your application and determine your eligibility. You and your healthcare provider will receive updates on your enrollment status. Once approved, Xarelto will be shipped to you or your physician's office[3]. ## Timeline and What to Expect While specific processing times are not publicly stated, the program recommends submitting complete applications with all required documentation to avoid delays[2]. Incomplete applications will take longer to process. Once approved, medication is typically shipped to your home or healthcare provider's office. ## Reauthorization and Refills Your assistance is not permanent. You will need to **reauthorize annually** to continue receiving free or low-cost Xarelto[2]. The program will notify you when it's time to renew. If your income, insurance status, or health coverage changes, you must notify the program within 30 days[8]. ## What If Your Application Is Denied? If you don't qualify for the Johnson & Johnson Patient Assistance Program, you have other options: - **Contact your healthcare provider** about alternative blood thinners that may be covered by your insurance or available through other assistance programs - **Use the Medicine Assistance Tool (MAT)** at **MAT.org** to search for other financial assistance resources available through different pharmaceutical companies[4] - **Ask about generic alternatives** or lower-cost medications your doctor might prescribe - **Contact a patient advocate** at organizations like Patient Advocate Foundation or NeedyMeds for additional resources ## Important Reminders - **Provide complete information:** Missing documents or incomplete sections will delay your application[2] - **Report changes:** Notify the program within 30 days if your income, insurance, or health status changes[8] - **Keep your prescription current:** You must have an active prescription from your healthcare provider to receive medication - **Annual reauthorization required:** Plan to reapply each year to continue receiving assistance ## Contact Information **Phone:** (833) 742-0791 **Hours:** Monday–Friday, 8:00 AM–8:00 PM ET[2][3] **Fax:** (833) 512-0497[2] **Online:** JJPatientAssistance.com or JanssenPatientAssistance.com/PA[3] ## Disclaimer This guide provides general information about the Johnson & Johnson Patient Assistance Foundation program for Xarelto. Program eligibility, requirements, and benefits may change. For the most current and accurate information, contact the program directly using the contact information above. This guide is not a guarantee of eligibility or assistance. Always consult with your healthcare provider about your treatment options and medication access.

Program information last verified: March 30, 2026