Program requires the submission of a request for coverage within 9 months post-Program initiation in order to remain eligible. By participating, patient acknowledges intent to pursue insurance coverage for MAYZENT †Eligible patients must have commercial insurance and a valid prescription for MAYZENT. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice. Program may not be combined with any third-party rebate, coupon, or offer. Valid only in the United States and Puerto Rico. Patient is responsible for complying with anyĪpplicable limitations and requirements of their health plan related to the use of the Program. Including any health insurance program or plan, flexible spending account, or health care savings account. Patient may not seek reimbursement for the value received from this Program from other parties, Program is not valid where prohibited by law. Patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, andĭeductibles. The value of this Program is exclusively for the benefit of Or (iii) where the patient’s insurance plan reimburses for the entire cost of the drug. Under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, Patient is responsible for any costs once limit is reached in a calendar year. The Program includes the Co-Pay Card, Payment Card (if applicable), and Rebate, Valid only for those with commercial insurance.
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