Void where prohibited by law, taxed, or restricted. Non-transferable, limited to one per person, cannot be combined with any other offer. Patient is responsible for applicable taxes, if any. If you are uninsured or if you are insured and your insurance does not cover or has a managed care restriction on your prescription (step-edit, prior authorization, or NDC block), AstraZeneca will pay up to the first $ 100, and you will be responsible for any remaining balance, for each 30-day supply (1 inhaler). TERMS OF USE: Eligible commercially insured/covered patients with no restrictions (step-edit, prior authorization, or NDC block) and a valid prescription for BREZTRI AEROSPHERE ® (budesonide, glycopyrrolate, and formoterol fumarate) Inhalation Aerosol who present this savings card at participating pharmacies will pay as low as $ 0 for each 30-day supply (1 inhaler) patient out-of-pocket expenses may vary. If you use a mail-order pharmacy, please contact your pharmacy provider to confirm if this offer will be accepted. This offer is not insurance and is restricted to residents of the United States and Puerto Rico. If you are enrolled in a state- or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs, or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees. Patients who are enrolled in a state- or federally funded prescription insurance program are not eligible for this offer. If you are under the age of 18, please have your parent, guardian, or healthcare provider request the information on your behalf.ĮLIGIBILITY: You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions. Please visit to review our Privacy Notice.ĪstraZeneca will not knowingly collect, use, or disclose personally identifiable information from a minor under the age of 18. If in the future you no longer want to receive health-related materials, call 1-80. Information provided by AstraZeneca does not take the place of talking to your healthcare provider about your treatment or condition.ĪstraZeneca or third parties working on its behalf will not sell or rent your personal information. This may include AstraZeneca or a third party working on AstraZeneca's behalf contacting me by telephone, e-mail and/or text message regarding AstraZeneca support programs that may be of interest to me. I understand that I may also receive ongoing information and support related to my condition which includes, but is not limited to, providing me with educational and promotional materials, information, special offers and services related to my therapy or my medical condition and for market research purposes, which includes contacting me to participate in focus groups, surveys or interviews. By registering today, you will receive information about BREZTRI, and may receive information about other respiratory medicines and services related to your condition.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |