Welcome EMSAM Saving Card
What is the EMSAM® Savings Card?
It's a savings offer that may be able to reduce your out-of-pocket expenses on EMSAM® prescriptions to as little as $20. Eligible patients who have commercial health insurance can receive up to $600 off each 30-day prescription of EMSAM® . You can print the savings offer from your computer or store it on your smartphone and present it to your pharmacist. Just present your card at the pharmacy each time you drop off or refill your prescription.
Use it again and again.
The EMSAM® Savings Card is reusable for up to twelve (12) times per calendar year.
See if you are eligible.
Complete the following question to find out whether you are eligible. Restrictions apply. See below for full Terms and Conditions.

* = Required Fields

* Do you have:

If you do not have insurance, unfortunately you are not eligible to use Mylan Advocate Savings Cards.
Unfortunately we cannot provide you with a Mylan Advocate Savings Card online. Please call 800-796-9526 for more information.
If you are covered by Medicare, Medicaid, or any other state or federally funded benefit program, unfortunately you are not eligible to use the Mylan Advocate Savings Cards.

* Your age:

If you are under 18 years of age, unfortunately you are unable to apply for a Mylan Advocate Savings Card.

Congratulations! You may be eligible to receive the EMSAM® Savings Card. Please complete the following fields and click "Submit" to confirm and receive your card.

Your Information




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By leaving the checkbox unchecked you agree to receive information about Mylan Inc. and its products. You will join a large online community of over 1 million individuals who recieve important product updates and exclusive healthcare content.

We do not sell your email address and you may opt out at any time. Deciding not to receive email communications will in no way affect eligibility for the Savings Card program.



EMSAM® (selegiline transdermal system) Savings Card Terms and Conditions

This Savings Card can be used to reduce the amount of your out-of-pocket expenses for EMSAM® (selegiline transdermal system) up to a maximum of $600 per 30-day prescription, after you pay the first $20 per 30-day prescription, while this program remains in effect. This offer can be used up to a total of 12 times per calendar year, with a savings cap of $7200 per calendar year while this program remains in effect. No other purchase is necessary. Valid prescription with Prescriber ID# is required. Mylan Specialty L.P. reserves the right to amend or end this program at any time without notice.

Eligibility Requirements: This Savings Card can be redeemed only by patients or patient guardians who are 18 years of age or older and who are residents of the United States and its territories. Patients must have commercial insurance. This program is not valid for uninsured patients (but may be used by commercially insured patients without coverage for EMSAM®) and patients who are covered by any state or federally funded healthcare program, including but not limited to any state pharmaceutical assistance program, Medicare (Part D or otherwise), Medicaid, Medigap, VA or DOD, or TriCare (regardless of whether EMSAM® is covered by such government program); not valid if the patient is Medicare eligible and enrolled in an employer-sponsored health plan or prescription benefit program for retirees; and not valid if the patient's insurance plan is paying the entire cost of this prescription. This program is void outside the US and its territories or where prohibited by law, taxed, or restricted. Absent a change in Massachusetts law, this program will no longer be valid for Massachusetts residents as of January 1, 2020.

This Savings Card is not health insurance. This Savings Card is not transferable, and the amount of the savings cannot exceed the patient's out-of-pocket expenses. This program cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription. This Savings Card is not redeemable for cash.

NOTICE: Data related to your use of this Savings Card may be collected, analyzed and shared with Mylan Specialty L.P. for market research and other purposes related to assessing coupon programs. Data shared with Mylan Specialty L.P. will be aggregated and de-identified, meaning it will be combined with data related to other savings card redemptions and will not identify you.

Patient Instructions: By using this Savings Card, you acknowledge that you currently meet the eligibility criteria and that you understand and will comply with the following additional terms and conditions:

 

Pharmacist Instructions: When you accept this Savings Card, you are certifying that you have received this Savings Card from an eligible patient; you have received a valid prescription for EMSAM® for an eligible patient; you have dispensed the product as indicated; you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription; and you will otherwise comply with these terms and all applicable terms and conditions. You further certify that your participation in this program is consistent with all applicable state laws and any obligations, contractual or otherwise, that you have as a pharmacy provider, and that you will report the use of this Savings Card to the patient's insurer if required.