get Your prescription at a generic price
Affordability is key for any medication. Teva’s Sildenafil Tablets, USP is the FDA-approved generic of Viagra® (sildenafil citrate) Tablets. And we offer a savings program to help keep your out-of-pocket costs in your pocket.
Savings card download
*Commercially insured patients may pay as little as $0 out of pocket per fill. Program allows 6 tablets per patient, with a maximum benefit up to $100 per fill. A minimum of 6 tablets per prescription is required. This offer is not available to patients eligible for prescription coverage by any state or federally funded healthcare programs. Maximum reimbursement limits apply. Patient out-of-pocket expenses may vary.
Terms, Conditions, and Eligibility Requirements for Teva’s Sildenafil Tablets Copay Savings Program
- To the Patient: You must present this offer and your primary insurance card to the pharmacist along with your prescription to participate in this program.
- Offer valid only for the following National Drug Codes:
- 25 mg - 00093-5341-56
- 50 mg - 00093-5342-56; 00093-5342-01
- 100 mg - 00093-5343-56; 00093-5343-01
- Insured Patients: For commercially insured patients, you may pay a copay as low as $0 for your out-of-pocket per fill for up to 6 Sildenafil Tablets prescriptions. A minimum of 6 tablets per prescription is required. Teva will pay up to $100 of your co-payment or other cost-sharing obligation per fill. Maximum reimbursement limits apply and patient out-of-pocket expenses may vary. Program allows 6 uses per patient before the expiration date printed on the card.
- Insured/Not Covered: For commercially insured patients whose insurance does not cover Sildenafil Tablets, you will pay a copay as low as $0 for your Sildenafil Tablets prescription. A minimum of 6 tablets per prescription is required. Teva will pay the remaining balance up to $100. This offer is not valid for uninsured/cash-paying patients. This offer is also not valid for patients eligible to have prescriptions paid for in part or in full by any state or federally funded healthcare programs, including but not limited to, Medicare or Medicaid, Medigap, VA, DOD, TRICARE, or by private health benefit programs which reimburse you for the entire cost of your prescription drugs. This card is not valid for patients who are Medicare eligible and are enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (e.g., patients who are eligible for Medicare Part D but receive a prescription drug benefit through a former employer). Government-insured beneficiaries excluded. By redeeming this offer, you certify that you are an eligible patient and you understand and agree to comply with the terms and conditions of this offer. Void if copied, transferred, purchased, altered, or traded, and where prohibited, taxed, and restricted by law. Void in the Commonwealth of Massachusetts. Void in the State of California after June 8, 2018. Offer not valid for patients under 18 years of age. The offer is only valid at participating pharmacies. This is not an insurance program and is not intended to substitute for insurance.
- This offer is restricted to residents of the United States and Puerto Rico. This offer may be changed or discontinued at any time without notice. This offer is limited to 1 per customer and may not be used or combined with any other discount, coupon, or savings offer. This offer expires on June 8, 2018. If you have any questions regarding your eligibility or benefits, or if you wish to discontinue your participation, please call the Sildenafil Tablets Copay Savings Program at 844-492- 9703.
- To the Pharmacist: When you use this offer you are certifying that you are dispensing Sildenafil Tablets to a patient eligible for this offer in compliance with the terms and conditions, and you have not submitted and will not submit a claim for reimbursement under any federal, state, or other governmental program for this prescription. Void where prohibited by law.
- Pharmacy Instructions for Privately Insured Patients: Submit the claim to the primary Third Party Payer first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code, (e.g. 8). The patient pay amount submitted will be reduced by up to $100 and reimbursement will be received from CHANGE HEALTHCARE.
- Pharmacy Instructions for Insured/Not Covered Patients: If the patient has commercial insurance but you receive a “not covered” response because Sildenafil Tablets is not on the patient’s formulary or is subject to prior authorization or step therapy and the patient has not met the criteria, continue the claim adjudication process and run the claim as secondary payer COB. Submit the claim from the primary Third Party Payer to CHANGE HEALTHCARE as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and process using Other Coverage Code (e.g. 3). The patient pay amount submitted will be reduced by up to $100 and reimbursement will be received from CHANGE HEALTHCARE.
- Valid Other Coverage Code required. For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at 800-433-4893.