Terms and Conditions
- This coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 4 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost.
- This coupon is valid for use 4 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription, for up to 4 qualifying prescriptions.
- This coupon is valid for up to a one-month's supply per prescription fill. This coupon may be redeemed only once every 21 days.
- No other purchase is necessary.
- This coupon is not transferable. No substitutions are permitted. This offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.
- This coupon is not insurance.
- Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), Medicare, a Medicare Part D or Medicare Advantage plan (regardless of whether a specific prescription is covered), TRICARE, CHAMPUS, Puerto Rico Government Health Insurance Plan ("Healthcare Reform"), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, "Government Programs").
- Subject to changes in state law, this coupon may become invalid for residents of Massachusetts prior to its expiration date.
- You must be 18 years of age or older to redeem this coupon. Patient, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through this offer. Patient is responsible for reporting receipt of coupon benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using this coupon, as may be required.
- This coupon can be used only by eligible residents of the United States or the Commonwealth of Puerto Rico at participating eligible retail or mail-order pharmacies in the United States or the Commonwealth of Puerto Rico. Product must originate in the United States or the Commonwealth of Puerto Rico.
- This coupon is the property of Merck and must be turned in on request.
- It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit this coupon. Void if reproduced. Void where prohibited by law, taxed, or restricted.
- Merck reserves the right to rescind, revoke, or amend this offer at any time without notice.
- Data related to your redemption of this coupon may be collected, analyzed, and shared with Merck, for market research and other purposes related to assessing coupon programs. Data shared with Merck will be aggregated and de-identified, meaning it will be combined with data related to other coupon redemptions and will not identify you.
- Expiration Date: 12/31/2022.