TERMS AND CONDITIONS
Eligibility Requirements
A patient may be eligible for the NEXLIZET & NEXLETOL Co-Pay Card if
they
meet the
eligibility
criteria below:
-
must be at least 18 years of age, AND
-
has a valid prescription for NEXLIZET or NEXLETOL, AND
-
has commercial prescription drug insurance, AND
-
is a resident of the United States, including the District of Columbia but excluding
territories (such as Puerto Rico and the US Virgin Islands), AND
-
is not enrolled in any state-, federal-, or government-funded healthcare program,
including but not limited to Medicare, Medicaid, Medigap, TRICARE of the
Department of Defense, or the Department of Veterans Affairs (VA) healthcare
program (collectively referred to as “Government Program”).
Should a patient have any change in insurance coverage or become enrolled in a Government Program
during their enrollment in the NEXLIZET & NEXLETOL Co-Pay Card
program, they must inform a NEXLIZET & NEXLETOL Co-Pay Card program
representative and will no longer be eligible for the NEXLIZET & NEXLETOL Co-Pay Card program. Also, if a patient is enrolled in a Government
Program, they may not use the NEXLIZET & NEXLETOL Co-Pay Card program
even if they elect to be processed as a commercial or discount insurance plan patient.
To determine if a patient is eligible for the NEXLIZET & NEXLETOL Co-Pay Card program, the patient must enroll online at www.NexCopay.com, or call
855-699-8814, and opt-in to the NEXLIZET & NEXLETOL Co-Pay Card
program. Esperion will evaluate the patient’s eligibility and communicate an eligibility decision to
the patient. Final patient eligibility determinations are provided by Esperion and/or its program
representatives.
Eligibility in the NEXLIZET & NEXLETOL Co-Pay Card program is for one
year. Patients must reenroll for NEXLIZET & NEXLETOL Co-Pay assistance
each year that they wish to participate in the program. If your card is lost or stolen, please visit
www.NexCopay.com, or call
855-699-8814.
Terms of Use
The following Terms of Use apply to use of the NEXLIZET & NEXLETOL Co-Pay Card by any patient deemed eligible to participate in the
program. These Terms of Use should be read together with the Privacy Policy at
https://www.esperion.com/
privacy-policy/.
Eligible patients with commercial prescription drug insurance coverage for NEXLIZET or NEXLETOL may
pay as little as $10 per fill. The NEXLIZET & NEXLETOL Co-Pay Card is not health insurance or a benefit plan. Distribution or
use of the NEXLIZET & NEXLETOL Co-Pay Card does not obligate use or
continuing use of any provider or continuing use of NEXLIZET or NEXLETOL. Patient is responsible for
reporting the receipt of all NEXLIZET & NEXLETOL Co-Pay Card savings
or reimbursement to any insurer, health plan, or other third party who pays for or
reimburses any part of the prescription filled using the Co-Pay Card,
as may be required.
The NEXLIZET & NEXLETOL Co-Pay Card is not valid for medications the
patient receives for free or that are eligible to be reimbursed by other healthcare or
pharmaceutical assistance programs that reimburse the patient in part or for the entire cost of
his/her Esperion medication. By using the NEXLIZET & NEXLETOL Co-Pay
Card, the patient agrees not to seek reimbursement from health insurance or any third party for all
or any part of the benefit received by the patient through the offer.
The NEXLIZET & NEXLETOL Co-Pay Card will be accepted by participating
pharmacies in the United States. To qualify for use of this NEXLIZET & NEXLETOL Co-Pay Card, the patient may be required to pay out-of-pocket expenses
for each prescription. The NEXLIZET & NEXLETOL Co-Pay Card program
does not cover costs associated with a patient visit to a doctor’s office including prescriber,
staff, administrative charges, labs, and other ancillary services. This NEXLIZET & NEXLETOL Co-Pay Card is only available with a valid prescription and cannot be
combined with any other rebate/coupon, free trial, or similar offer for the specified prescription.
This offer is not conditioned on any past, present or future purchase, including refills.
Use of this NEXLIZET & NEXLETOL Co-Pay Card must be consistent with
all relevant health insurance requirements and payer agreements. The NEXLIZET & NEXLETOL Co-Pay Card may not be sold, purchased, traded, or offered for sale,
purchase, or trade. The NEXLIZET & NEXLETOL Co-Pay Card is limited to
one per person during this offer period and is non-transferable. Void where prohibited or otherwise
restricted by law.
Esperion reserves the right to rescind, revoke, amend, or terminate the program without notice at
any time.
If you have questions or need additional support, call 855-699-8814 (8:00 am-8:00 pm ET,
Monday-Friday, excluding holidays).
BY USING THIS PROGRAM, YOU UNDERSTAND AND AGREE TO COMPLY WITH THESE TERMS AND CONDITIONS. ANY
VIOLATIONS OR NON-COMPLIANCE WITH THESE TERMS AND CONDITIONS MAY RESULT IN YOUR ELIGIBILITY
DETERMINATION FOR THE PROGRAM BEING RESCINDED.
Have
questions about NEXLIZET? Call 1-833-NEXLIZET (1-833-639-5493) or see frequently asked questions.
