Frequently Asked Questions (FAQs) About the LIPITOR Savings Program*

Similar documents
Frequently Asked Questions (FAQs) About the LIPITOR Savings Program*

Get a 1-month supply of ENTRESTO at no cost to you *

Pay as little as a $10 co-pay a month for ENTRESTO *

Get a 1-month supply of ENTRESTO at no cost to you*

OVERVIEW PROCESS SERVICES HARVONI. Simply on Your Side. Please see full Prescribing Information, including Patient Information.

PERSONAL SUPPORT PROGRAM SERVICES AND SUPPORT TO HELP YOU GET STARTED

NeedyMeds

Celgene Patient Support Learn about financial help for IDHIFA

NeedyMeds

PLEASE CHECK ALL BOXES THAT APPLY AND COMPLETE THE APPROPRIATE SECTION(S) OF THE FORM

Moving from Pediatric to Adult Care: Prescription Medicines, Supplies, and Equipment

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Celgene Patient Support Learn about financial help for REVLIMID

Prescription Savings Club

Celgene Patient Support Learn about financial help for POMALYST

PLEASE CHECK ALL BOXES THAT APPLY AND COMPLETE THE APPROPRIATE SECTION(S) OF THE FORM. Patient name: _Date of birth: Sex: M F

Contents General Information General Information

Celgene Patient Support Learn about financial help for ABRAXANE

Intel Corporation Connected Care Arizona Care Network

NeedyMeds

NeedyMeds

SAVINGS GUARANTEED FEEL BETTER. This Program is NOT Insurance. Membership

GROUP INSURANCE. Generic drugs. Their positive effect on your wallet

Medicare s new prescription drug insurance called

2018 FAQs. Prescription drug program. Frequently Asked Questions from employees

FREQUENTLY ASKED QUESTIONS ABOUT THE CVS CAREMARK PRESCRIPTION DRUG PROGRAM

Questions and Answers. When should I use mail order pharmacy services? What is my co payment for drugs? What is my co payment for preferr

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Medicare s new prescription drug insurance called

The Merck Access Program ENROLLMENT FORM

NeedyMeds

DoD NAF HBP. Retirees, Medicare and Aetna AREA Luncheon

PLEASE CHECK ALL BOXES THAT APPLY AND COMPLETE THE APPROPRIATE SECTION(S) OF THE FORM. Patient name: Date of birth: Sex: M F

NeedyMeds

WORKSAFENB DIRECT-PAY PRESCRIPTION DRUG PROGRAM

A Quick Start Guide to Your New Health Plan

Health Care in California: The Chronically Ill

Your. Multi-tiered. Prescription Drug Benefit Program. bcnepa.com

Lynn Hutchins Psychiatric Nurse Practitioner, PLLC

USES: This medication is used along with a non-drug program (including diet changes) to treat cholesterol and lipid disorders.

Allergies None Penicillin Sulfa Drugs Codeine Aspirin Tape Latex Iodine-Shellfish. Other allergies: Medications

XEOMIN (incobotulinumtoxina) PATIENT SAVINGS PROGRAM

Patient Registration Form

Medicare Notebook. Helping you make sense of Medicare

Drug coverage in New Brunswick

NeedyMeds

NeedyMeds

NeedyMeds

Pharmacy Coverage Guidelines are subject to change as new information becomes available.

Medicare s new prescription drug insurance called

Introducing the benefits of the HDHP. Get the most out of the High Deductible Health Plan

Endocrinology of the Rockies, PC. PATIENT REGISTRATION FORM E. 9th Ave. Ste. 245, Denver, CO 80220

fax. FAX completed and signed enrollment form to BMS Access Support at

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Getting Started with Medicare

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Getting Started with Medicare

NeedyMeds

Your medicine, your way. Start using home delivery today.

CENTER CITY DERMATOLOGY STEPHEN HESS, M.D., Ph.D. MEDICAL HISTORY

For households exceeding 4 members, add $21,600 for each additional member to the $125,500 referenced above.

PATIENT REGISTRATION

Medicare s new prescription drug insurance called

Your Pharmacy Benefits Handbook

Prior Authorization Required From DXC Technology

PATIENT INFORMATION NOTICE OF PRIVACY POLICY PATIENT ACKNOWLEDGEMENT

Picking a Medicare Prescription Drug Plan Basic facts you need to know and questions you should ask

PATIENT REGISTRATION AND HISTORY FORM ~ FAMILY EYE HEALTH ASSOCIATES

January 1 December 31, 2013 Evidence of Coverage: Your Medicare Prescription Drug Coverage as a Member of Express Scripts Medicare

Getting started with Medicare

NeedyMeds

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Patient Information. Financial Handbook For Liver Transplant Patients

SBCFF Modified Rx 10/30/45 Prescription Drug Benefits

News and Updates on Your Health Benefits Program

HealthyYou. New! Receive Your Plan Materials Electronically! Taking Medications as Prescribed page 2. Create Your InTouch Account page 4

Trustees Announce New Programs to Save Members of-pocket Expense

Pfizer encompass Co-Pay Assistance Program for INFLECTRA :

Medical Plan User Guide

Your Health Insurance: Questions and Answers

NeedyMeds

A CONSUMER S GUIDE TO CANCER INSURANCE

Patient Resource Guide

Your Guide to Medicare Special Needs Plans (SNPs)

Asuris Northwest Health Medicare Advantage PPO Plans. Decision Guide

DEFICIT REDUCTION ACT AND FALSE CLAIMS POLICY INFORMATION FOR All MASSACHUSETTS WORKFORCE MEMBERS

All About. RX Drugs. And What. You Need. Now HEALTHY SMART

PHARMACY BENEFIT MEMBER BOOKLET

Patient Registration Form

FREQUENTLY ASKED QUESTIONS

2345 Court Drive Gastonia, NC Phone: Fax:

Medicine and Surgery of the Foot PATIENT INFORMATION PERSON RESPONSIBLE FOR PAYING THE BILL FAMILY PHYSICIAN INFORMATION HEALTH INSURANCE INFORMATION

Fair Drug Prices for Nova Scotians

Prescription Drug Coverage

Medicare Made Simple

Decision Guide Regence Medicare Advantage HMO Plan

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Emergency Room Visit Covered Only If It s A True Emergency. Pre-Certify Non-Emergency Hospital. Stays As Well As Emergency Stays

Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

Transcription:

Frequently Asked Questions (FAQs) About the LIPITOR Savings Program* *Terms and Conditions apply. Please see page 10 for details. You may pay less by receiving the generic. Below are some FAQs about the LIPITOR Savings Card that you may still have after visiting LIPITOR.com. Q: What is the LIPITOR Savings Card? A: The LIPITOR Savings Card allows certain eligible patients to get a 30-day supply of LIPITOR for $30. Other patients may be eligible to pay as little as $4 a month, depending on their insurance. It may work if you have insurance, are on Medicare Part D, or have no insurance at all, and is valid for every prescription or refill through December 31, 2016. Q: Do I need to activate my card? A: If you registered for your card online or by phone, it will come activated. If you received the card from your doctor, in the mail, or via email, you will need to activate it. This only takes a few steps. To activate, visit LIPITOR.com or call the number on the front of the card. Q: How does the LIPITOR Savings Card work? A: 1. Once the card is activated, present it to your pharmacist when you drop off your prescription or request a refill. 2. During the payment process, the pharmacist will run your card, and your out-of-pocket cost will be either $30 or $4, depending upon your eligibility. 3. Visit LIPITOR.com to see how much you may pay. Q: What does the LIPITOR Savings Card cost? A: It is free to sign up and requires no membership fees. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 1

Q: How long is my LIPITOR Savings Card valid? A: Once activated, your LIPITOR Savings Card is valid for every prescription or refill through December 31, 2016. Q: How is this card different from previous LIPITOR cards? A: The LIPITOR Savings Card provides more flexibility than previous LIPITOR cards by expanding insurance coverage, which helps more eligible patients get LIPITOR. Q: How do I get a replacement if I lose or damage my card? A: If your LIPITOR Savings Card gets lost or damaged, simply call us at 1-800-314-7957, and we ll help you get a new one. Q: How can I have my name/email address removed so that I m not contacted again in the future? A: To remove your name from future LIPITOR communications, including refill reminders, please call the toll-free number, 1-877-375-6627. Eligibility Q: Who is eligible to use the LIPITOR Savings Card? A: This offer is for non-medicaid patients, aged 18 and older, living in the United States and Puerto Rico. This offer is not available to residents of Massachusetts, or to patients who have federal or state health insurance coverage, except for Medicare Part D. Medicare Part D patients may use the LIPITOR Savings Card, but cannot use their benefit in conjunction with the card. Q: Who may be eligible for the $4 co-pay for a 30-day supply of LIPITOR? A: You may be eligible for the $4 co-pay for a 30-day supply if: 1. You are a commercial patient using insurance that covers brand-name LIPITOR, and 2. Your out-of-pocket expense for a 30-day supply (30 tablets) is $130 or less. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 2

Q: Who may be eligible for a $30 co-pay for a 30-day supply? A: You may be eligible for a $30 co-pay for a 30-day supply if: 1. You pay for brand-name LIPITOR without use of health insurance coverage, or 2. You have private insurance and your co-pay is greater than $130/month. Please note the following Terms and Conditions for the $30 co-pay category: a. No health insurance is accepted or required; b. Patients participating in this category cannot seek reimbursement for a purchase of LIPITOR from any third-party insurance entity during the term of this offer; c. Medicare Part D patients may participate in this card program, but cannot use any part of their Medicare Part D or prescription benefit for LIPITOR during the term of this offer; d. Out-of-pocket expenditures under this card program cannot be applied toward a patient s Medicare Part D true out-of-pocket (TrOOP) expenses. Q: Can I use my LIPITOR Savings Card if I don t have insurance? A: Yes. If you are eligible, no insurance is accepted or required for the $30 co-pay. Just take your activated card and prescription for LIPITOR to the pharmacy to get your 30-day supply for $30. Q: Does the card work with private or commercial health insurance? A: Yes, the LIPITOR Savings Card may work with insurance. Here are the details: Insured patients whose out-of-pocket cost for LIPITOR is $130 or less may pay $4 for a 30-day supply; Insured patients whose out-of-pocket cost for LIPITOR is more than $130 may pay $30 for a 30-day supply. Note that the $30 co-pay patients cannot seek reimbursement for a purchase of LIPITOR from any third-party insurance entity, including Medicare Part D, during the term of this offer. Q: I have Medicare Part D coverage. Can I use the LIPITOR Savings Card? A: Yes. If eligible, you will pay $30 for your 30-day supply of LIPITOR. However, you cannot use the LIPITOR Savings Card in conjunction with your Medicare Part D benefit. Out-of-pocket expenditures under this card program cannot be applied toward a patient s Medicare Part D true out-of-pocket (TrOOP) expenses. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 3

Q: If I am eligible for the $30 co-pay and I am a Medicare Part D patient, can I use my insurance in combination with the LIPITOR Savings Card? A: No. Medicare Part D patients may participate in the LIPITOR Savings Card program but cannot use any part of their Medicare Part D prescription benefit for LIPITOR during the term of this offer. Q: I am a Medicaid recipient. Can I use the LIPITOR Savings Card? A: Unfortunately, Medicaid and other federal or state government insurance recipients are currently not eligible to participate. Q: How does someone get a LIPITOR Savings Card? A: It s easy. To see if you are eligible, answer a few questions on the Get a Card section of LIPITOR.com or call our toll-free number, 1-877-375-6620. How do I use the card? Q: Where can I use my LIPITOR Savings Card? A: You can use your card at any participating pharmacy. To find a pharmacy that has accepted a LIPITOR card, visit our Pharmacy Finder at LIPITOR.com. Q: Do I have to take my LIPITOR Savings Card to the pharmacy every time I pick up my prescription? A: Yes, be sure to present your activated card to your pharmacist when you drop off your prescription and every time you go to refill it, so your pharmacist knows that you want brand-name LIPITOR instead of the generic, atorvastatin calcium. Q: Do I need a new prescription to use the LIPITOR Savings Card? A: To use the LIPITOR Savings Card, all participants must have a valid prescription for brand-name LIPITOR. Be sure to ask your doctor to specify LIPITOR on your prescription with a note such as No Substitutions, Brand Medically Necessary, or Dispense As Written (DAW) to ensure you receive brand-name LIPITOR. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 4

Q: Can I use the LIPITOR Savings Card on a previously filled prescription? A: No, the LIPITOR Savings Card can only be used for new prescriptions that are filled after you have activated the card. Q: How much will I pay for a 60- or 90-day prescription with the LIPITOR Savings Card? A: Depending on your cost ($4 or $30 for a 30-day supply), you will pay amounts directly related to the prescription duration you are purchasing. Therefore, if your out-of-pocket cost is $4, you will pay $8 for a 60-day supply and $12 for a 90-day supply. If your out-of-pocket cost is $30, you will pay $60 for a 60-day supply and $90 for a 90-day supply of LIPITOR. Q: Can I use the card more than once a month? Can I let someone else use it? A: You can only use the card once every 30 days. The card is for individual use only. Q: Is there a limit to how much I can use my card? A: Yes, you can only use the card for a maximum savings of $2500 per calendar year. Q: I have an older LIPITOR card (LIPITOR $4 Co-pay Card or 30 for $30 Card). Do these cards still work? A: Yes, these cards will still work. You may also sign up for the LIPITOR Savings Card on LIPITOR.com and enjoy the same benefits. Q: Does the LIPITOR Savings Card work with mail-order prescriptions? A: Yes. We ll reimburse you for the cost of your prescription over and above your eligible cost. Simply pay for your LIPITOR prescription and mail a copy of your original pharmacy receipt (cash register receipt NOT valid) with product name, date, and amount circled to: LIPITOR Savings Card 2250 Perimeter Park Drive, Suite 200 Morrisville, NC 27560 Please be sure to include a copy of the front of your LIPITOR Savings Card, your name, and your mailing address. All rebate submissions will be processed within 10 to 14 business days of the date we receive your information. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 5

Q: Does Pfizer have a list of pharmacies that carry LIPITOR? A: Pharmaceutical companies do not maintain current lists of pharmacies that carry their products, since pharmacies and their wholesaler distributors decide which medicines to stock. To find a pharmacy near you that has recently carried LIPITOR, visit our Pharmacy Finder at LIPITOR.com. If your local pharmacy does not carry LIPITOR, you may ask if it s possible for them to order the brand for earliest possible pick-up. Make sure you leave enough time to fill your prescription so that you don t miss a dose, and continue to take your medication as prescribed by your doctor. Q: My doctor switched my LIPITOR prescription to the generic, atorvastatin calcium. Can I continue to use my LIPITOR Savings Card? A: No, but be sure to ask your doctor to specify LIPITOR on your prescription with a note such as No Substitutions, Brand Medically Necessary, or Dispense As Written (DAW) to ensure you receive brand-name LIPITOR instead of the generic, atorvastatin calcium. You will then be able to use your LIPITOR Savings Card. You can also ask your pharmacist to give you brand-name LIPITOR instead of the generic, atorvastatin calcium. Q: Can I use my LIPITOR Savings Card for other medications I am taking? A: No. Your card is for brand-name LIPITOR only. If you are interested in similar offers for other Pfizer products, visit www.mypfizerbrands.com. Q: My current LIPITOR card ($4 or 30 for $30 card) expired. What do I need to do to get a new card? A: You may sign up for a new LIPITOR Savings Card on LIPITOR.com or get one from your doctor. Once your card is registered, present it at the pharmacy to enjoy the same benefits. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 6

How much does it cost? Q: How much will I pay using the LIPITOR Savings Card? A: Eligible insured patients whose plans cover LIPITOR up to a $130 out-of-pocket cost will pay $4 for a 30-day supply; Eligible insured patients whose plans do not cover LIPITOR, or do not cover it over the $130 out-of-pocket cost, will pay $30 for a 30-day supply; Eligible uninsured patients, as well as Medicare Part D patients, will pay $30 for a 30-day supply. If you are not sure if your insurance company covers LIPITOR, you may contact them to find out how LIPITOR is covered under your specific plan. Q: Can I combine this with other coupon offerings or the LIPITOR $4 Co-pay Card? A: No. The LIPITOR Savings Card cannot be combined with any other co-pay card, rebate, coupon, free trial, or similar offer on the same prescription. By participating in this offer, you agree not to seek reimbursement from any third-party insurance entities. Q: Why would my co-pay change? A: Your co-pay is dependent upon your insurance coverage. If you lose insurance, change insurance companies, or your plan no longer covers LIPITOR, your co-pay is subject to change. Q: My pharmacist was unable to process my LIPITOR Savings Card. How do I receive my reimbursement? A: If you already filled your prescription, you can receive reimbursement via a mail-in rebate. In order to receive the mail-in rebate, please send a copy of your LIPITOR Savings Card and a copy of the original pharmacy receipt with the product name, date, and amount circled to: LIPITOR Savings Card 2250 Perimeter Park Drive, Suite 200 Morrisville, NC 27560 All rebate submissions will be processed within 10 to 14 business days of the date we receive your information. Be sure to include your name and your mailing address. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 7

Pharmacy information Q: What happens when I go to the pharmacy? A: You will present the activated card to the pharmacist when you request your prescription or refill. Your pharmacist will then process your LIPITOR Savings Card as necessary. Because this program works differently from other cards, pharmacists may not be familiar with how to process it. They can check the instructions on the card or call 1-855-612-1950. Q: What does it mean if my pharmacist says that I have to get No Substitutions, Brand Medically Necessary, or Dispense As Written (DAW) on my script to receive brand-name LIPITOR instead of the generic, atorvastatin calcium? A: Be sure to ask your doctor to specify LIPITOR on your prescription with a note such as No Substitutions, Brand Medically Necessary, or Dispense As Written (DAW) to ensure you receive brand-name LIPITOR at the pharmacy and not the generic, atorvastatin calcium. Your pharmacist may be able to call your doctor to see if you can be switched to brand-name LIPITOR. Once switched, if eligible, you will be able to use your LIPITOR Savings Card. Q: What happens if my local pharmacy does not have LIPITOR in stock? A: If your local pharmacy does not carry LIPITOR, you may ask if it s possible for them to order the brand for the earliest possible pick-up. Make sure you leave enough time to fill your prescription so you don t miss a dose, and continue to take your medication as prescribed by your doctor. Q: My pharmacist switched my LIPITOR prescription to the generic, atorvastatin calcium. Can I continue to use my LIPITOR Savings Card? A: No. You can t use this card with the generic version. But you can let your pharmacist know that you want brand-name LIPITOR. Your pharmacist can then switch you back to brand-name LIPITOR, which will allow you to use the card if you are eligible. For more information, please call 1-800-314-7957 or visit LIPITOR.com. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 8

INDICATION LIPITOR (atorvastatin calcium) is a prescription medicine that lowers cholesterol in the blood. It lowers the LDL-C ( bad cholesterol) and triglycerides in your blood. It can raise your HDL-C ( good cholesterol) as well. LIPITOR is for adults and children over 10 whose cholesterol does not come down enough with exercise and a low-fat diet alone. LIPITOR can lower the risk for heart attack, stroke, certain types of heart surgery, and chest pain in patients who have heart disease or risk factors for heart disease such as age, smoking, high blood pressure, low HDL-C, or heart disease in the family. LIPITOR can lower the risk for heart attack or stroke in patients with diabetes and risk factors such as eye problems, kidney problems, smoking, or high blood pressure. IMPORTANT SAFETY INFORMATION LIPITOR (atorvastatin calcium) tablets are not for everyone, including anyone who has previously had an allergic reaction to LIPITOR. It is not for those with liver problems. And it is not for women who are nursing, pregnant, or may become pregnant. If you take LIPITOR (atorvastatin calcium) tablets, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all your medical conditions and all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before starting LIPITOR and during your treatment if you have symptoms of liver problems. Tell your doctor if you have diabetes. Elevated blood sugar levels have been reported with statins, including LIPITOR. Common side effects are diarrhea, upset stomach, muscle and joint pain, and changes in some blood tests. Patients should always ask their doctors for medical advice about adverse events. You may report an adverse event related to Pfizer products by calling 1-800-438-1985 (US only). If you prefer, you may contact the US Food and Drug Administration (FDA) directly. The FDA has established a reporting service known as MedWatch where healthcare professionals and consumers can report serious problems they suspect may be associated with the drugs and medical devices they prescribe, dispense, or use. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 9

*LIPITOR SAVINGS CARD TERMS AND CONDITIONS By using the LIPITOR Savings Card (the Card ), you attest that you meet the eligibility criteria and will comply with the Terms and Conditions described below: You will pay $4 for a 30-day supply (30 tablets) if: you use commercial/private insurance and your out-of-pocket expense for a 30-day supply of brand-name LIPITOR is $130 or less. You will pay $30 for a 30-day supply (30 tablets) if: you do not use prescription health coverage to purchase your brand-name LIPITOR under this program or you use commercial/private insurance and your out-of-pocket expense for a 30-day supply of brand-name LIPITOR is $130 or more. In addition: a) Medicare Part D patients may participate in this Card Program, but cannot use any part of their Medicare Part D prescription benefit for LIPITOR during the term of this offer. b) Out-of-pocket expenditures under this Card Program cannot be applied towards a patient s Medicare Part D true out of pocket (TrOOP) expenses. c) Patients participating in this category cannot seek reimbursement for a purchase of LIPITOR from any third party insurance entity during the term of this offer. This offer is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid 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 ]). For all eligible patients, you can only qualify for up to $2500 of savings per calendar year. After a maximum of $2500, you will pay usual monthly out-of-pocket costs. This Card cannot be combined with any other rebate/coupon, free trial, discount, prescription savings card, or similar offer for the specified prescription. The Card will be accepted only at participating pharmacies. This Card is not health insurance. Offer valid only in the U.S. and Puerto Rico, but not for Massachusetts residents or where otherwise prohibited by law. The Card is limited to 1 use per person per month during this offering period and is not transferable. It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit this Card. Pfizer reserves the right to rescind, revoke or amend the Card Program without notice at any time. You must be 18 or older to participate in this Program. Card Program expires December 31, 2016. No membership fees. For reimbursement when using mail order, mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date and amount circled to: LIPITOR Savings Card 2250 Perimeter Park Drive, Suite 200 Morrisville, NC 27560 Be sure to include a copy of the front of your Savings Card, your name and mailing address. Please see full Prescribing and Patient Information for LIPITOR at LIPITOR.com. 10 PP-LIP-USA-0124 2016 Pfizer Inc. All rights reserved. March 2016