Co-Pay Plus Terms & Conditions: Offer valid only when used with commercial health insurance. Offer is not available where:
- the patient has federal or state health plan benefits (eg, Medicare, Medicaid, TRICARE, VA);
- the health plan reimburses for the entire cost of the drug;
- the health plan provides no coverage for the drug; or
- prohibited by law.
The amount of funding available from the Program is subject to an annual limit. Novartis reserves the right to discontinue the availability of co-pay assistance if, at any time, Novartis determines that the patient is subject to a co-pay maximizer program. Co-pay maximizers are programs implemented by health plans in which the amount of the patient’s out-of-pocket cost is increased to reflect the availability of support offered by a manufacturer assistance program. The patient is responsible for all costs once available funding from the Program is exhausted.
The Program is designed exclusively for the benefit of the patient. The amount of available funding may be reduced or eliminated if it is not credited by the patient’s health plan toward the patient’s out-of-pocket obligations (eg, deductibles, annual out-of-pocket maximums). Program funding may also be reduced or eliminated if the patient’s health plan, directly or indirectly, adjusts, reduces, or waives the patient’s health plan benefits based on the availability of, or the patient’s enrollment in, the Program, or otherwise acts in a manner that materially affects these Terms and Conditions.
Only the patient or their legal guardian or caregiver may enroll the patient in the Program. Health plans, specialty pharmacies, pharmacy benefit managers, and their agents and representatives (individually and collectively “Plan Administrators”), are prohibited from enrolling patients in the Program.
Patients in the Program are responsible for notifying Novartis of any change in their prescription drug health plan coverage that may conflict or otherwise affect compliance with these Terms and Conditions. By accepting Program funding from Novartis on behalf of participating patients, Plan Administrators agree to not take any action that materially affects compliance with these Terms and Conditions.
Patients may not seek reimbursement for the value received from the Program from any other party (eg, health plans, flexible spending or healthcare savings accounts). Patients are responsible for complying with any applicable limitations and requirements of their health plan related to their use of the Program.
Valid only in the United States and Puerto Rico.
The Program is not health insurance, and may not be combined with any third-party rebate, coupon, or offer. Novartis reserves the right to rescind, revoke, or amend the Program at any time without notice.