•Eligible commercially insured patients pay as little as $15 per prescription
•Program benefit applies to medication cost only and does not cover any costs to administer the medication.
•Patients will be responsible for any outofpocket costs above the maximum annual benefit
•Card is valid through December 31 of the year of activation; On January 1 of the following year, the card automatically resets and is subject to annual limits if the prescription benefit remains the same
•For assistance or additional information, call 8334154436, Monday through Friday, 8 am–8 pm ET