TERMS AND CONDITIONS
A patient may be eligible for the NEXLIZET & NEXLETOL Co-Pay Card if they meet the eligibility criteria below:
- must be at least 18 years of age, AND
- has a valid prescription for NEXLIZET or NEXLETOL, AND
- has commercial prescription drug insurance, AND
- is a resident of the United States, including the District of Columbia but excluding
territories (such as Puerto Rico and the US Virgin Islands), AND
- is not enrolled in any state-, federal-, or government-funded healthcare program,
including but not limited to Medicare, Medicaid, Medigap, TRICARE of the
Department of Defense, or the Department of Veterans Affairs (VA) healthcare
program (collectively referred to as "Government Program").
Should a patient have any change in insurance coverage or become enrolled in a Government Program during
their enrollment in the NEXLIZET & NEXLETOL Co-Pay Card program, they must
inform a NEXLIZET & NEXLETOL Co-Pay Card program representative and will
no longer be eligible for the NEXLIZET & NEXLETOL Co-Pay Card program.
Also, if a patient is enrolled in a Government Program, they may not use the NEXLIZET & NEXLETOL
Co-Pay Card program even if they elect to be processed as a commercial or
discount insurance plan patient.
To determine if a patient is eligible for the NEXLIZET & NEXLETOL Co-Pay
Card program, the patient must enroll online at www.NexCopay.com,
or call 855-699-8814, and opt-in to the NEXLIZET & NEXLETOL Co-Pay Card
program. Esperion will evaluate the patient's eligibility and communicate an eligibility decision to
the patient. Final patient eligibility determinations are provided by Esperion and/or its program
Eligibility in the NEXLIZET & NEXLETOL Co-Pay Card program is for one year.
Patients must reenroll for NEXLIZET & NEXLETOL Co-Pay assistance each year
that they wish to participate in the program. If your card is lost or stolen, please visit
www.NexCopay.com, or call 855-699-8814.
Eligible patients with commercial prescription drug insurance coverage for NEXLIZET or NEXLETOL may pay
as little as $10 per fill. The NEXLIZET & NEXLETOL Co-Pay
Card is not health insurance or a benefit plan. Distribution or use of the NEXLIZET & NEXLETOL
Co-Pay Card does not obligate use or continuing use of any provider or continuing
use of NEXLIZET or NEXLETOL. Patient is responsible for reporting the receipt of all NEXLIZET & NEXLETOL
Co-Pay Card savings or reimbursement to any insurer, health plan, or
other third party who pays for or reimburses any part of the prescription filled using the Co-Pay
Card, as may be required.
The NEXLIZET & NEXLETOL Co-Pay Card is not valid for medications the patient
receives for free or that are eligible to be reimbursed by other healthcare or pharmaceutical assistance
programs that reimburse the patient in part or for the entire cost of his/her Esperion medication. By using
the NEXLIZET & NEXLETOL Co-Pay Card, the patient agrees not to seek reimbursement
from health insurance or any third party for all or any part of the benefit received by the patient through the offer.
The NEXLIZET & NEXLETOL Co-Pay Card will be accepted by participating pharmacies in the United
States. To qualify for use of this NEXLIZET & NEXLETOL Co-Pay Card, the patient may be
required to pay out-of-pocket expenses for each prescription. The NEXLIZET & NEXLETOL Co-Pay
Card program does not cover costs associated with a patient visit to a doctor's office including prescriber, staff, administrative
charges, labs, and other ancillary services. This NEXLIZET & NEXLETOL Co-Pay Card is only
available with a valid prescription and cannot be combined with any other rebate/coupon, free trial, or similar offer for the
specified prescription. This offer is not conditioned on any past, present or future purchase, including refills.
Use of this NEXLIZET & NEXLETOL Co-Pay Card must be consistent with all relevant health insurance
requirements and payer agreements. The NEXLIZET & NEXLETOL Co-Pay Card may not be sold, purchased,
traded, or offered for sale, purchase, or trade. The NEXLIZET & NEXLETOL Co-Pay Card is limited to
one per person during this offer period and is non-transferable. Void where prohibited or otherwise restricted by law.
Esperion reserves the right to rescind, revoke, amend, or terminate the program
without notice at any time.
If you have questions or need additional support, call 855-699-8814 (8:00 am-8:00 pm
ET, Monday-Friday, excluding holidays).
BY USING THIS PROGRAM, YOU UNDERSTAND AND AGREE TO COMPLY WITH
THESE TERMS AND CONDITIONS. ANY VIOLATIONS OR NON-COMPLIANCE
WITH THESE TERMS AND CONDITIONS MAY RESULT IN YOUR ELIGIBILITY
DETERMINATION FOR THE PROGRAM BEING RESCINDED.