Terms and Conditions
*Try Taltz for as little as $5 a month. $5 Monthly offer subject to a monthly cap and a separate maximum annual benefit of $16,000. $25 Monthly offer subject to a monthly and annual cap of wholesale acquisition cost plus usual and customary pharmacy charges. If you meet program eligibility requirements, have commercial insurance, and your insurance provider covers Taltz, you are eligible to pay $5 monthly. If you meet program eligibility requirements, have commercial insurance, and your insurance provider denies coverage for Taltz, you are eligible to pay $25 monthly. To continue to participate in the $25 monthly program, patients who qualify are required to initiate a benefits investigation and request for coverage within 6 months post program initiation, as well as 12 months post program initiation, to verify coverage status and potential eligibility for the $5 monthly program. Card activation for both the $5 and $25 monthly offers is good for up to 36 months from patient qualification into the program. Subject to the terms and conditions of the program, patients may be eligible to re-enroll provided they continue to meet program criteria.
*Eligibility Criteria: By using the Taltz 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 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 (12/31/2021); (ii) the date an AB-rated generic equivalent for Taltz becomes available; or (iii) June 30, 2019, absent a change in Massachusetts state law. If you live in California, the card expires on the earlier of: (i) the expiration date of this card (12/31/2021) or (ii) the date an FDA approved therapeutically equivalent for Taltz or over the counter product with the same active ingredients 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 Taltz. 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. This Card expires on 12/31/2021. Patients must first use their card by 12/31/2018 and are eligible for savings for up to 36 months of therapy.
