Patients who are enrolled in Medicare, Medicaid, or another state or federal health care program may use the Savings Card if paying for the prescription covered by the Savings Card is outside of their government insurance benefit, and no claim is submitted to Medicare, Medicaid or any federal or state health care program.

You must deduct the value of this Savings Card from any reimbursement request submitted to your private insurance plan, either directly by you or on your behalf.

This Savings Card is not valid when the entire cost of your prescription drug is eligible to be reimbursed by your private insurance plan or other private health or pharmacy benefit programs.

The value of this Savings Card is limited to $100 per use or the amount of your co-pay, whichever is less for each of the 4 uses, up to a maximum annual savings of $400.

Eligible patients may pay as little as $45 by using the Savings Card.

This Savings Card is not valid for prescriptions that are reimbursed, in whole or in part, by Medicaid, Medicare, Tricare, Veterans Affairs health care, or other federal or state health care 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”).

By using the Estring Savings Card, you acknowledge that you currently meet the eligibility criteria and will comply with the Terms and Conditions described below:

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