To submit a medical co-pay claim you will need:
Please note: You may only submit a claim if the patient is commercially insured and is not participating in any Federal Healthcare Program (including Medicare, Medicaid, Tricare, or any other state or federal medical pharmaceutical benefit program or pharmaceutical assistance program).
Download the Pfizer Co-pay Claim Form
Download the GeneTogether Co-pay Claim Form
Need Help? Pfizer HCP Portal User Guide