Symbicort copay card code#

Program managed by Connective RX, LLC on behalf of Amarin Pharma, Inc. For any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at 1-80. Reimbursement will be received from CHANGE HEALTHCARE. The patient is responsible for the first $9 and the card pays up to the next $150.

Symbicort copay card code#

A valid Other Coverage Code (e.g., 1) is required. Pharmacist Instructions for Cash-Paying Patients Without Insurance: Submit this claim to CHANGE HEALTHCARE. The patient is responsible for the first $9 after the patient's insurance has been applied and the card pays up to $150 per 1-month fill and $450 per 3-month fill, up to a maximum savings of $2250 annually. Pharmacist Instructions for Patients with Commercial Insurance Claims: Submit the claim to the primary Third Party Payer first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code, (e.g., 8). Cardholders with questions, please call 1-85. Follow the dosage instructions given by the doctor. Patient Instructions: In order to redeem this card you must have a valid prescription for VASCEPA ® (icosapent ethyl) and otherwise meet all eligibility criteria. Void where prohibited by law, taxed or restricted.

This offer is not valid for those patients under 18 years of age or patients whose plans do not permit use of a copay card. May not be used to obtain prescription drugs paid for by Federal or State Healthcare Programs including Medicare Part D. Not for use by residents of the Commonwealth of Massachusetts. The patient is responsible for the first $9 of their copay after the patient's insurance has been applied and the card pays up to the next $150 per 1-month fill and $450 per 3-month fill, up to a maximum savings of $2250 annually. If you would like to view our Privacy Policy, click here. We will protect your privacy in accordance with our Privacy Policy. The information you provide will only be used by Amarin and parties acting on its behalf, to send you the materials you requested, and other helpful information and updates on VASCEPA or very high triglyceride levels, as well as related treatments, offers, and services. Amarin understands that your personal and health information is private. For SMS Terms, click here.īy clicking 'Register' you are enrolling in the VASCEPA Savings Card Program and certify that you have read, understand, and meet all Eligibility Criteria for the program. Terms & Conditions, and Privacy Policy apply. Consent is not a condition of purchase of goods or services. By choosing Text message as your primary communication method, you agree to receive refill reminders as text messages to your phone number provided and opt-in to VASCEPA recurring copay program messages.