Help patients get started on ORILISSA

Your eligible commercially insured patients may pay as little as $5 per month* with the Orilissa Savings Card

Patients can get started by calling 1-800-ORILISSA to enroll and activate the Savings Card, if eligible.*

Get help with prior authorization requests

CoverMyMeds provides a no-cost digital resource for submitting prior authorization (PA) forms for many specialty drugs covered under most drug plans. Call 1-866-452-5017 or visit

for more information

Downloadable resources for your office

Along with support from CoverMyMeds, you can download the instructions and templates below for helpful guidelines and tips for navigating the prior authorization process.

Prior Authorization Common Criteria

Prior Authorization Tracker Template

Appeal Letter Sample Template

Letter of Medical Necessity Sample Template

This information is for informational purposes only and is not intended to provide reimbursement or legal advice. The information presented here does not guarantee payment or coverage.