By using the AXIRON Savings Card ("Card"), you attest that you meet the eligibility criteria and will comply with the Terms and Conditions described below:
Offer void where prohibited by law. This offer is invalid for patients without commercial insurance coverage or those whose prescription claims for AXIRON are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DOD, VA, TRICARE/CHAMPUS, or any State Patient or Pharmaceutical Assistance Program. If you live in Massachusetts, the Card expires on the earlier of: (i) the expiration date of this Card (December 31, 2015) or (ii) the date an AB rated generic equivalent for AXIRON becomes available. Available only in the US and Puerto Rico for residents of the US and Puerto Rico.
By accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Card. This offer is not valid with any other program, discount, incentive, or similar offer involving AXIRON. It is prohibited for any person to sell, purchase or trade; or to offer to sell, purchase or trade, or to counterfeit this Card. This offer may be terminated, rescinded, revoked or amended by Lilly USA, LLC at any time without notice.
This Card is not health insurance.
Card must be first used by December 31, 2015, and will be honored for the next 11 refills before December 31, 2016.
© 2014. ALL RIGHTS RESERVED. AXIRON is a trademark owned or licensed by Eli Lilly and Company, its subsidiaries or affiliates.