By participating in the FINGOLIMOD Instant Savings Program for FINGOLIMOD CAPSULES manufactured by MSN Laboratories Private Limited and labeled by Apotex, you acknowledge that you meet the eligibility criteria and will comply with the terms and conditions described below:
- You may not use the FINGOLIMOD Instant Savings Program if you have prescription drug coverage under Medicaid, Medicare, TRICARE, the Federal Employee Health Benefit Program, or other federal or state healthcare programs including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico (formerly known as "La Reforma de Salud"). You may not use the FINGOLIMOD Instant Savings Program if you are uninsured or have no prescription drug coverage for FINGOLIMOD.
- The FINGOLIMOD Instant Savings* Program is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs, which reimburse you for the entire cost of your prescription drugs (i.e. you have no cost-sharing obligation).
- Offer not available for residents of California or Massachusetts or where prohibited by law. Void if copied, transferred, purchased, altered or traded. This is not an insurance program. This offer is restricted to residents of the United States and Puerto Rico. You must deduct the savings received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.
- If eligible, patient receives up to $750 towards cost-sharing obligation for FINGOLIMOD per 30-day fill, up to $9,000 per calendar year. In the event the patient's cost-sharing obligation for FINGOLIMOD under their health insurance is more than $750 per 30-day supply, the patient will be responsible for any cost-sharing beyond $750 for each 30-day supply. The FINGOLIMOD Instant Savings Program cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription.
- The FINGOLIMOD Instant Savings Program will be accepted only at participating pharmacies.
- The FINGOLIMOD Instant Savings Program is not health insurance.
- The offer is good only in the U.S. and Puerto Rico.
- Apotex reserves the right, at its sole discretion, to amend, to rescind, revoke, or terminate the offer at any time.
- There are no membership fees for this savings program.
- If you receive co-payment assistance under the FINGOLIMOD Instant Savings Program, your personal information will be used to process payment for your prescription under such program through an Apotex vendor.
For questions about enrolling in the program or using the card, please call toll free at (855)-820-3230. Pharmacists, please call 855-825-1678 for questions about processing the card.