Pay as little as $0 for up to 12 months with the Emgality Savings Card*
Simply activate and present the Savings Card to the pharmacist when you pick up your prescription at your local pharmacy. This offer is for eligible, commercially insured patients only.
We will need your HIPAA† authorization to work on your behalf to help you pay as little as possible. We believe that by you taking a little extra time now to provide HIPAA authorization, we can help you pay as little as possible for your Emgality medication. Requesting an Emgality Savings Card shouldn’t take more than a few minutes. If you do not want to provide HIPAA authorization online, please contact The Emgality Answers Center at 1-833-EMGALITY (1-833-364-2548) Mon to Fri, 9 AM to 8 PM ET to request a Savings Card.
*Terms and Conditions:
Offer good for up to 12 months until 12/31/2020 if healthcare provider submits a prior authorization form or coverage exception request, when required, to the patient’s insurance provider. $0 monthly offer for commercially insured with insurance provider coverage, subject to wholesale acquisition cost plus usual and customary pharmacy charges and a separate $4900 maximum annual cap. $0 monthly offer for commercially insured without insurance provider coverage, subject to monthly and separate annual cap of wholesale acquisition cost plus usual and customary pharmacy charges. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. This offer is invalid for patients without commercial drug insurance or those whose prescription claims are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DOD, VA, TRICARE/CHAMPUS, or any state patient or pharmaceutical assistance program. Offer void where prohibited by law and subject to change or discontinue without notice. Card activation is required. Subject to additional terms and conditions, which can be found at here.
†As a reminder, HIPAA is the Health Insurance Portability and Accountability Act that provides data privacy and security to protect your health information.