Terms and Conditions:
By using the Emgality Savings Card (“Card”), you attest that you meet the eligibility criteria, agree to, and will comply with the Terms and Conditions described below:
Offer good until 12/31/2021 for up to 12 months of Emgality. Patients with commercial drug insurance may be able to pay as little as $0 for their first fill of Emgality. For the 2nd and subsequent fills, patients must have coverage for Emgality through their commercial drug insurance plan to continue to pay as little as $0 per fill. Offer subject to a monthly savings of wholesale acquisition cost plus usual and customary pharmacy charges and a separate $4900 maximum annual savings. Participation in the program requires a valid patient HIPAA authorization. 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. If you live in Massachusetts, the Card expires on the earlier of: (i) the expiration date of this Card (12/31/2021); (ii) the date an AB-rated generic equivalent for Emgality becomes available; or (iii) 12/31/2020, absent a change in Massachusetts state law. If you live in California, the Card expires on the earlier of: (i) the expiration date of this Card (12/31/2021) or (ii) the date an FDA-approved therapeutically equivalent for Emgality or over-the-counter product with the same active ingredients becomes available.
Available only in the US and Puerto Rico for residents of the US and Puerto Rico. By accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Card. This offer cannot be combined or utilized with any other program, discount, discount card, cash discount card, coupon, incentive, or similar offer involving Emgality. It is prohibited for any person to sell, purchase, or trade; or to offer to sell, purchase, or trade; or to counterfeit this Card. This offer may be terminated, rescinded, revoked, or amended by Lilly USA, LLC at any time without notice. Card activation required. This Card is not health insurance. This Card expires on 12/31/2021.
