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BYETTA Savings Card

The MySavingsRx Card can help you pay as little as $25 a month for your BYETTA prescription TODAY.*

*Eligibility requirements and terms of use apply.

AZhelps Savings Card Logo

*Subject to eligibility. Restrictions apply. See below for details.

If eligible, show your card and prescription to your pharmacist for instant savings.

ELIGIBILITY REQUIREMENTS AND TERMS OF USE

ELIGIBILITY REQUIREMENTS

  • You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions
  • Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees
  • If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient
  • This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age

TERMS OF USE

Eligible commercially insured patients with a valid prescription for BYETTA® (exenatide) injection who present this savings card at participating pharmacies will pay as low as $25 per 30-day supply subject to a maximum savings of $0 per 30-day supply. If you pay cash for your prescription, AstraZeneca will pay up to the first $150, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply. Patient is responsible for applicable taxes, if any.

  • Non-transferable, limited to one per person, cannot be combined with any other offer. Void where prohibited by law, taxed or restricted
  • Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer
  • AstraZeneca reserves the right to rescind, revoke, or amend this offer, eligibility and terms of use at any time without notice
  • This offer is not conditioned on any past, present or future purchase, including refills
  • Offer must be presented along with a valid prescription at the time of purchase
  • If you have any questions regarding this offer, please call 1-844-631-3978

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

Pharmacist Instructions for a Patient with an Eligible Third Party:

For Insured/Covered Patients: Submit the claim to the primary Third-Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB with patient responsibility amount and a valid Other  Coverage  Code  of 8. This will reduce the eligible patient’s out-of-pocket costs to as low as $0 per 30-day supply subject to a maximum savings of $0. Reimbursement will be received from Change Healthcare.

Pharmacist Instructions for Insured/Not Covered Patients:

Submit the claim to the primary Third-Party Payer first, if the primary claim submission shows a managed care restriction (step-edit, prior authorization or NDC block), continue the claim adjudication process and submit the balance due to Change Healthcare as a Secondary Payer COB with patient responsibility amount and a valid Other  Coverage  Code  of 3. Eligible patients will receive a maximum savings of $0 per 30-day supply; patient’s out-of-pocket cost may vary. Reimbursement will be received from Change Healthcare.

Pharmacist Instructions for a Cash-Paying Patient:

Submit this claim to Change Healthcare. A valid Other Coverage Code (eg, 1) is required. The card will cover up to $150 per 30-day supply. Reimbursement will be received from Change Healthcare.

Valid Other Coverage Code Required. For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-422-5604.

We understand that even with insurance, the monthly out-of-pocket costs for your medicine can really add up. But we want you to know we’re doing something about it.

To help with prescription costs, we’re offering eligible patients the opportunity to pay just $25 for BYETTA injection. All it takes is an eligible prescription and a MySavingsRx Card.

Your savings will continue for as long as your doctor prescribes BYETTA (within a 24-month period) and you remain eligible. Your card even saves you money when you fill your prescription through a mail-order pharmacy.

Getting Started Is As Easy As 1-2-3:

  1. You must have a valid prescription for BYETTA
  2. Click on the link below to request your MySavingsRx Card
  3. Present your card and prescription to your pharmacist. (Mail-order customers, call the number on your card and ask for customer service.)

We’re working to reduce your out-of-pocket prescription costs. So take advantage of the MySavingsRx Card today.

ELIGIBILITY REQUIREMENTS AND TERMS OF USE

ELIGIBILITY REQUIREMENTS

  • You may be eligible for this offer if you are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions
  • Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees
  • If you are enrolled in a state or federally funded prescription insurance program, you may not use this savings card even if you elect to be processed as an uninsured (cash-paying) patient
  • This offer is not insurance, is restricted to residents of the United States and Puerto Rico, and to patients over 18 years of age

TERMS OF USE

Eligible commercially insured patients with a valid prescription for BYETTA® (exenatide) injection who present this savings card at participating pharmacies will pay as low as $25 per 30-day supply subject to a maximum savings of $0 per 30-day supply. If you pay cash for your prescription, AstraZeneca will pay up to the first $150, and you will be responsible for any remaining balance, for each monthly prescription. Other restrictions may apply. Patient is responsible for applicable taxes, if any.

  • Non-transferable, limited to one per person, cannot be combined with any other offer. Void where prohibited by law, taxed or restricted
  • Patients, pharmacists, and prescribers cannot seek reimbursement from health insurance or any third party for any part of the benefit received by the patient through this offer
  • AstraZeneca reserves the right to rescind, revoke, or amend this offer, eligibility and terms of use at any time without notice
  • This offer is not conditioned on any past, present or future purchase, including refills
  • Offer must be presented along with a valid prescription at the time of purchase
  • If you have any questions regarding this offer, please call 1-844-631-3978

BY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE.

Pharmacist Instructions for a Patient with an Eligible Third Party:

For Insured/Covered Patients: Submit the claim to the primary Third-Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB with patient responsibility amount and a valid Other  Coverage  Code  of 8. This will reduce the eligible patient’s out-of-pocket costs to as low as $0 per 30-day supply subject to a maximum savings of $0. Reimbursement will be received from Change Healthcare.

Pharmacist Instructions for Insured/Not Covered Patients:

Submit the claim to the primary Third-Party Payer first, if the primary claim submission shows a managed care restriction (step-edit, prior authorization or NDC block), continue the claim adjudication process and submit the balance due to Change Healthcare as a Secondary Payer COB with patient responsibility amount and a valid Other  Coverage  Code  of 3. Eligible patients will receive a maximum savings of $0 per 30-day supply; patient’s out-of-pocket cost may vary. Reimbursement will be received from Change Healthcare.

Pharmacist Instructions for a Cash-Paying Patient:

Submit this claim to Change Healthcare. A valid Other Coverage Code (eg, 1) is required. The card will cover up to $150 per 30-day supply. Reimbursement will be received from Change Healthcare.

Valid Other Coverage Code Required. For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-422-5604.

Start Saving Today!*

Get your MySavingsRx Savings Card here.

*Eligibility requirements and terms of use apply.

 GET STARTED

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