Terms and Conditions for SOLOSEC® Savings Program
- Not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any state- or federally funded program. This includes Medicare, Medigap, Medicaid, TRICARE®, Veterans Affairs (VA) or Department of Defense (DoD) health coverage, Employer Group Waiver Plans, or where prohibited, taxed or otherwise restricted by law.
- Must be a US resident.
- Must be 18 years of age or older to redeem this offer for yourself or a minor.
Terms and Conditions:
- Offer valid for up to 12 fills.
- A commercially insured patient with plan coverage for SOLOSEC® may pay as little as $25.
- Cash-pay patients are eligible to participate and may pay as little as $75. "Cash-pay patient" means an uninsured patient or a patient who has commercial insurance, but SOLOSEC® is not covered on the plan's formulary or has an NDC block, prior authorization, step edit or other restriction that has not been met. Medicare Part D enrollees who are in the prescription drug coverage gap ("donut hole") are not considered and are not eligible for this offer.
- Patient out-of-pocket costs may vary. Patient is responsible for any remaining balance after offer is applied and applicable taxes, if any.
- This co-pay card is not valid when the entire cost of a patient's prescription drug is eligible for reimbursement from a private insurance plan or other private health or pharmacy benefit programs.
- Patient and pharmacy agree not to seek reimbursement for all or any part of the benefit received by the patient through this offer from any third-party payer and are each responsible for making any required reports of use of this offer to any third-party payer who pays any part of the prescription filled.
- Valid only at participating pharmacies in the US.
- No other purchase is necessary.
- This card and offer are not health insurance.
- The selling, purchasing, trading, or counterfeiting of this offer is prohibited by law. Void if reproduced.
- Not valid with other offers. This offer has no cash value. No cash back.
- Lupin Pharmaceuticals, Inc. reserves the right to amend, revoke or terminate this offer without notice.
- By applying this offer, pharmacist is certifying that (i) the patient meets the eligibility criteria, (ii) you have not submitted and will not submit a claim for reimbursement under any state- or federally funded program for this prescription; and (iii) participation is not contrary to pharmacy agreements with third-party payers or laws or regulations applicable to pharmacies.
- Patient and pharmacist understand and agree to comply with the eligibility requirements and terms and conditions of this offer as described above.