Terms and Conditions
TO THE PHARMACY:
TO THE PATIENT:
Eligibility & Restrictions:
You may be eligible if you are covered by commercial insurance, your insurance does not cover the full cost of the prescription, or you are a cash-paying patient. No other purchase is necessary. This offer is not Health Insurance. No substitutions permitted.
This card is not transferable. You are not eligible if you are enrolled in any state or federally funded healthcare program, including, but not limited to, Medicare, Medicare Part D, Medicaid (including Medicaid managed care), Medigap, VA, FEHB, DoD, TRICARE®, or a state pharmacy assistance program. In addition, you must be 18 years or older and a legal resident of the US or Puerto Rico. Offer void where prohibited by law, taxed, or restricted. May not be used with any other discount, trial offer, or other offer. Hikma Specialty USA Inc. reserves the right to rescind, revoke, or amend this program without notice. Participation in this program confirms that this offer is consistent with your insurance coverage, if any, and that you will report the value received if required by your insurance provider. By using this card, you certify that you understand and will comply with the terms and conditions. For questions, please call 1-877-259-6893, 8 am-7 pm ET, Monday-Friday. Other conditions may apply.
DoD=US Department of Defense; FEHB=Federal Employees Health Benefits; PCN=Processor Control Number; VA=US Department of Veterans Affairs.