No Prescription coverage

Discount Prescription Plan Form

This discount drug card is a great way for you and your family to save on Prescription Drugs. The savings will be provided right at the pharmacy and can be as high as 65% off of AWP. This card is accepted at nearly 58,000 pharmacies nationwide including major chains and independent pharmacies. Savings will be different depending on the medication and the pharmacy utilized.

To use this card:

  • Take your script to a pharmacy in the network.
  • Show the discount card to the pharmacy each time you fill a script.
  • Discounts will be provided right at the pharmacy.
  • Once the discount is provided, you will be responsible for the balance of the drug cost.

To apply for a discount prescription plan card, please complete your first name. last name and contact details below.

First Name *

Last Name *

Email *


Frequently Asked Questions

Q: Is this card the same as regular insurance?
A: No, this is not insurance. This card allows you to get your prescriptions at a discounted price.
Q: Do I have to pay a fee to use this card?
A: No.
Q: When can I start using this card? A: You can start using this card immediately.
Q: Is my personal information kept private?
A: Yes, 4D is HIPAA compliant.
Q: Do I have to show my card to the pharmacy every time I go?
A: Yes, you will need to present your card at the pharmacy each time you pick up a prescription.
Q: Can I use this card at any pharmacy?
A: Nearly every pharmacy in the country accepts this discount drug card.

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