Terms and Conditions:
For patients whose prescriptions are covered by
commercial insurance, use of this card may reduce your copayment
responsibility to as little as $45.
For patients whose prescriptions
are not covered by either commercial or Medicare, use
of this card may reduce your cost for prescriptions to as little as
$45.
This program is subject to overall maximum support amounts.
This coupon is not valid for prescriptions paid for in part or full by
Medicaid, Tricare, DOD, VA or any state or federally funded program
(excluding Medicare).
Patients that have prescription drug coverage
under Medicare Part D or Medicare Advantage may take advantage
of this offer, provided that they acknowledge that by doing so they
will not seek any prescription coverage or reimbursement from their
insurer for the cost of prescriptions, or report any amounts paid for
prescriptions as part of their "true out of pocket expenses" under
Medicare Part D or Medicare Advantage prescription drug plan.