A patient is eligible for this promotion if their commercial health plan copay for CIPRODEX® Otic is more than . This offer is not valid for patients who are enrolled in Medicare Part D, Medicaid, Medigap, VA, DOD, Tricare, or any other government-run or government sponsored health care program pharmacy benefit. Patients without private insurance are ineligible for this program.
Offer applies only to CIPRODEX® Otic prescriptions filled on or before 9/30/16.
Eligible commercially insured patients may pay as little as in out-of-pocket expenses for each 7.5mL bottle of CIPRODEX® Otic with a maximum benefit per bottle of 5. Offer good for up to three (3) 7.5mL bottles of CIPRODEX® Otic for a single patient. Patient must be six (6) months or older to be eligible. No other purchase is necessary.
This offer may not be combined with any other savings, discount, free trial, or other similar offer for the same prescription. The savings card is not transferable, is void if reproduced, and has no cash value. The savings card is not health insurance. Alcon reserves the right to rescind, revoke or amend this offer without notice at any time. Use of this card is subject to applicable state and federal laws and is void where prohibited.
Present your card to your pharmacist along with an eligible prescription for Ciprodex® Otic each time you fill your prescription. The prescriber ID# must be identified on the prescription. This offer is not valid for patients who are enrolled in Medicare Part D, Medicaid, Medigap, VA, DOD, Tricare, or any other government-run or government-sponsored health care program with a pharmacy benefit. When you use this card, you are certifying that you understand the program rules, regulations, and terms and conditions and that you will comply with them. You may not use this card if prohibited by your insurer. You are responsible for any reporting of the use of this card required by your insurer. If you have any questions, please call 1-844-236-8027 (8:00 am to 8:00 pm ET, Monday-Friday).
When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, government-run or government sponsored health care program with a pharmacy benefit. If primary coverage exists, input card information as secondary coverage (not to exceed the copay amount or 5, whichever is less) and transmit using the COB segment of the NCPDP transaction. Submit transaction to McKesson Corporation using BIN #610524. Acceptable discounts will be displayed in the transaction response. Acceptance of this card and your submission of claims are also subject to the Terms and Conditions posted at www.mckesson.com/mprstnc. If you have any questions, please call McKesson Help Desk at 1-844-236-8027 (8:00 am to 8:00 pm ET, Monday-Friday).
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