astellasreimbursement

The VESIcare Vantage Program provides you with up to $25 off your out-of-pocket expenses.

You may receive the Vantage Program card in one of two ways if you are eligible:

1. Directly from their healthcare provider
2. Online at www.vesicare.com
   • You will be able to download and print a temporary card that can be activated immediately from the Web site
   • Subsequently, a Vantage Program card will be sent to you in the email

Please note: The VESIcare Vantage Program may not be used if the VESIcare prescription is paid in part or full by any state or federally funded program. You CANNOT use this offer if you are enrolled in Part D of Medicare, Medicaid, or any similar federal or state program, including a state pharmaceutical assistance program. Also, you CANNOT use this offer if you are eligible for Medicare and you are also enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees (that is, you are eligible for Medicare Part D, but you receive a prescription drug benefit through a former employer). Further, if you are a resident of Massachusetts, this offer is valid only if you are paying the entire cost of the prescription yourself (i.e., your insurance does not cover any of the cost of your prescription). Your acceptance of this offer must be consistent with the terms of any drug benefit provided by your health insurer, health plan, or private third-party payer, as may be required. This offer may not be used with any other discount, coupon, or offer. Only an original card will be accepted and must be presented to your pharmacist at the time you have the prescription filled—not valid if reproduced. Offer good only in USA, excluding Puerto Rico. Not transferable. Void where prohibited by law, taxed, or restricted. Limit 1 per purchase. Astellas Pharma US, Inc. reserves the right to rescind, revoke, or amend this offer without notice. By tendering the card, you certify that: (i) you have read the above terms, (ii) you meet the eligibility criteria listed above, and (iii) you will otherwise comply with the terms above.

The enrollment process is simple. Call the VESIcare Vantage Program Support Line at 1-866-514-6797 and provide the following information:

• 9-digit number from your VESIcare Vantage Program card
• Name
• Last 4 digits of their phone number
• Zip code
• Date of birth
• Medicare/Medicaid status

Once the patient has provided this information, the VESIcare Vantage Program will be activated. To receive the instant rebate, simply present the VESIcare Vantage Program to the pharmacy.

Patients who receive their VESIcare prescriptions by mail can also take advantage of the VESIcare Vantage Program. Most mail order facilities accept the card.  However, if your mail order facility does not, you may utilize our mail-in option by filling out the Mail Order section of the Vantage Program brochure.