MyRX4U: Get Your Card

If You Are 65+ or on Social Security Disability, Sign Up For Your FREE Prescription Discount Card

Get the FREE MyRX4U Card and start saving on prescription medications today! There are NO enrollment fees, NO activation charges, and NO periodic payments. Use the card as much as you like, completely free of charge. Simply fill out your information below, and we’ll send your personalized card through the mail. We’ll also send you a digital copy to print from home or display on your smart phone and tablet.

Become a Card Member

First Name

Last Name

Date of Birth (must match your prescription)

Email Address

Home Phone

Cell Phone

Check this box if you've lost your card and would like us to send you a replacement card in the mail.

Street Address or P.O. Box

Apartment, Suite, Unit, Building

City

State

Zip Code

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By clicking the submit button below, I understand that this discount prescription plan is NOT insurance or a Medicare prescription drug plan. I am aware that this prescription drug card is NOT affiliated with the U.S. government or the federal Medicare program. By clicking submit I also consent to sharing the information I provided above with third party insurance companies, which allows them to contact me regarding insurance coverage and/or my Medicare benefits.