#Dimethyl fumarate copay assistance free#
This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. Void if prohibited by law, taxed, or restricted. This offer is not valid for residents of Massachusetts. Offer good only in the USA, including Puerto Rico, at participating pharmacies. Amneal Pharmaceuticals LLC reserves the right to rescind, revoke, or amend this offer without notice.
Offer applies only to prescriptions filled before the program expires. Maximum savings limit applies patient out-of-pocket expense may vary.This offer is not valid for cash-paying patients. Patients may not use this card if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This card is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs.This offer is only good for use by patients with a valid prescription for an eligible product with an approved indication at the time the prescription is filled and dispensed to the patient.Patient will receive a maximum of $75 off per monthly prescription fill for their out-of-pocket cost.įor pharmacy processing questions, please call 33. Submit the SECONDARY claim to PDMI under BIN: 610020. Process a Coordination of Benefits (COB/split bill) claim using the patient’s prescription insurance for the PRIMARY claim. To Pharmacist: Offer valid for SECONDARY claims only. By using this offer, you acknowledge that you meet the Eligibility Criteria and will comply with the Terms and Conditions set forth below. This offer is valid for a maximum savings of $75 per monthly prescription fill. Mention this offer to your pharmacy along with a valid dimethyl fumarate prescription for an FDA-approved use. To Patient: Commercially insured patients can use this copay card to reduce out-of-pocket expenses on eligible prescriptions filled with Amneal Dimethyl Fumarate DR Capsules (see strengths listed above). If you have any questions, please feel free to call 33.Eligible, commercially insured patients may receive up to $75* off their out-of-pocket cost for their monthly Amneal Dimethyl Fumarate DR Capsules prescription.Present this card or BIN, Group and ID numbers to your pharmacist along with a valid prescription.See Eligibility and Terms below.Įxclusively for Amneal-labeled Dimethyl Fumarate Delayed-Release Tablets: *Max benefit of $75 per monthly prescription fill.
Save up to $75* for each prescription of Amneal Dimethyl Fumarate DR Capsules
#Dimethyl fumarate copay assistance pdf#
Research & Development We invest significantly in new product developmentĬlick here for a PDF of the dimethyl fumarate copay card.Ĭlick here to download full Prescribing Information.About We challenge convention so healthy can be possible.