To apply for the Abilify patient assistance program, download the Otsuka Patient Assistance Foundation (OPAF) application for your specific injectable, complete the patient section, have your prescriber complete and sign their section, and submit it with proof of income online, by fax, or by mail.1Otsuka Patient Assistance Foundation. OPAF Care Connect Online applications get an eligibility decision within two business days; faxed applications within five.2Otsuka Patient Assistance Foundation. OPAF Care Connect Patient Portal
Which Abilify Products the Program Covers
OPAF covers two long-acting injectables: Abilify Maintena and Abilify Asimtufii (both aripiprazole extended-release injectable suspension).3Otsuka Patient Assistance Foundation. Patient Application Forms Oral Abilify tablets are not included in this program. If tablets are what you take, ask your prescriber about other manufacturer discount cards or community assistance options rather than filing an OPAF form.
Who Qualifies
The program is for patients who are uninsured or underinsured, meaning you have no insurance or your plan does not adequately cover the cost of your prescribed Abilify injectable.1Otsuka Patient Assistance Foundation. OPAF Care Connect Plans that exclude the medication outright, or that have exhausted their annual benefit limit for it, generally make you eligible.
Income is measured against the federal poverty guidelines published each year by the Department of Health and Human Services. OPAF does not publish its exact income cap on its public site, so if your household income is modest and you are not sure whether you qualify, apply and let OPAF make the determination.
What to Gather Before You Start
Incomplete paperwork is the most common reason applications stall, so pull your documents together first. OPAF’s FAQ lists these as acceptable proof of income:
- Your most recent federal income tax return (Form 1040 or equivalent)
- W-2 forms from the previous tax year, covering all employers
- Your two most recent pay stubs if tax documents are unavailable4Otsuka Patient Assistance Foundation. General FAQs – Section: Patient and Caregiver FAQ
If government benefits are your income, include your Social Security benefit statement or unemployment compensation records instead. Whatever you submit should clearly show gross annual income for every adult counted in your household.
You will also need a valid government-issued ID and your current address and phone number for the patient section.
Filling Out the Form
Download the correct form for your medication, Abilify Maintena or Abilify Asimtufii, from the OPAF patient forms page.3Otsuka Patient Assistance Foundation. Patient Application Forms The form has two sections.
Patient Section
Enter your full legal name, date of birth, home address, and phone number. Indicate your insurance status and attach your income documentation. Read and sign the patient authorization. Without your signature, OPAF will not process the form.
Prescriber Section
Your healthcare provider fills in their name, office address, National Provider Identifier (NPI), and the specific medication, dosage, and frequency being prescribed, then signs the form. Coordinate with your doctor’s office so both sections are complete before submission. A form missing either signature gets kicked back.
How to Submit
OPAF accepts applications three ways. The online portal is the fastest by a wide margin.
Online
Through the OPAF Care Connect Patient Portal, you create an account, complete the application digitally, upload your income documents, and submit in a single session. Eligibility decisions come back within two business days.2Otsuka Patient Assistance Foundation. OPAF Care Connect Patient Portal The portal also emails you when your status changes, when a shipment is on its way, and when annual re-enrollment is due.
Fax
Fax the completed, signed application and all supporting documents to 1-844-727-6274. Faxed applications are processed within five business days.2Otsuka Patient Assistance Foundation. OPAF Care Connect Patient Portal Keep the fax confirmation page. If anything goes missing in transit, that receipt is your proof the packet was sent.
You can mail the application and documentation to the processing address printed on the form. Mail takes longer, and processing times for mailed applications are not published separately, so use fax or the online portal if your need is urgent.
After You Submit
OPAF reviews your income documentation, insurance status, and prescriber information. If a required document is missing or unclear, the review takes longer, and an incomplete application left unresolved can be denied after 90 days. Check your status through the Care Connect portal if you applied online, or call OPAF if you submitted by fax or mail.
Approval or denial is communicated to both the patient and the prescribing provider. If you are approved, medication is provided at no cost for up to one year.5PrescriberPoint. Otsuka Patient Assistance Foundation (OPAF)
How You Receive the Medication
Because both covered products are long-acting injectables that a healthcare professional must administer, OPAF ships them directly to your prescriber’s office or a local care center, not to your home.4Otsuka Patient Assistance Foundation. General FAQs – Section: Patient and Caregiver FAQ Your prescriber can specify an alternative shipping address if you receive your injection at a different clinic than the one that wrote the prescription. Shipping is covered by the program.
Confirm with your doctor’s office that each shipment has arrived and schedule your injection accordingly. If a shipment is delayed, contact OPAF rather than waiting. Gaps in long-acting injectable therapy can affect your treatment.
Renewing Each Year
Approval lasts up to one year. Before it expires, you must re-enroll by submitting updated income and insurance information. The Care Connect portal sends email reminders as renewal approaches, which is one reason the online route is easier to manage over time.2Otsuka Patient Assistance Foundation. OPAF Care Connect Patient Portal Submit your renewal paperwork early so your shipments are not interrupted. If your income or insurance situation has changed, pull together fresh documentation before you start.
If You’re Denied
OPAF does not publicly outline a formal appeal process. Your denial notice should explain the reason. The common causes are incomplete documentation, income above the threshold, or having insurance that already covers the medication. If the problem was missing paperwork, you can often reapply with the documents OPAF needs. If your income was slightly over the cap, ask your prescriber whether the manufacturer runs any other discount or copay assistance for Abilify injectables, and look into community health centers and state pharmaceutical assistance programs as alternatives.