LIVALO Employee Copay Savings Program

Terms and Conditions

† LIVALO Employee Dependent Savings Card (the Card) will save you on out-of-pocket costs (your co-pay) for a 30-, 60-, or 90-day supply of LIVALO. Participating employees and dependents are eligible to participate in this program.

To Patients: Present this Card with your valid prescription for LIVALO and pay $0 for a 30-, 60-, or 90-day supply of LIVALO. Keep this Card and present it with each prescription or refill. Restrictions apply. Please call 1-844-567-9504 with any questions about LIVALO Savings Card offer.

To Pharmacists: Submit the claim to the Primary Payer first, then submit the balance due to Capital Rx as a Secondary Payer as a co-pay only using Other Coverage Code of 8.

The patient will pay $0 for a 30-, 60-, or 90-day supply of LIVALO You will receive this in your reimbursement from Capital Rx, plus a handling fee.

To the Pharmacist ONLY: For any questions regarding Capital Rx online processing, please call 1-844-306-9173.

Eligibility Requirements: Void where prohibited by law. Kowa Pharmaceuticals reserves the right to rescind, revoke or amend this program without notice. Offer not valid for patients eligible for benefits under Medicaid (including Medicaid managed care), Medicare, TRICARE, Veterans Affairs, or similar state or federal programs. Offer void where prohibited, taxed, or otherwise restricted. Offer good only in the USA. No generic substitution with this offer.