*Eligibility: This offer is good for eligible patients purchasing up to a 30-day (up to 60 tablets) supply of VIMOVO® (naproxen/esomeprazole magnesium) delayed-release tablets and may not be used for any other product. This offer is good for the purchase of VIMOVO manufactured for AstraZeneca Pharmaceuticals LP and lawfully purchased from an authorized retailer or distributor in the United States or its territories. This offer is not insurance and is not valid for mail order or prescriptions purchased under Medicaid, Medicare, or similar federal or state programs, or for patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees or for patients under 18 years of age. Offer not valid where prohibited by law, taxed, or restricted. Offer is not transferable, is limited to one per person and may not be combined with any other offer. Offer must be presented along with a valid prescription for VIMOVO at the time of purchase.
Offer: If you have commercial insurance, you may pay no out-of-pocket costs at the pharmacy counter. You will receive up to $75 in savings on your out-of-pocket costs per prescription for up to 12 prescription fills. If you pay cash for your prescription, you will receive up to $75 in savings on your out-of-pocket costs for your prescription for up to 12 prescription fills. First use must occur by 03/31/2014. Offer expires 14 months from date of first use. AstraZeneca reserves the right to change or discontinue this offer at any time without notice. If you have any questions regarding this offer, please call 1-877-358-4668.
Pharmacist instructions for a patient with an eligible Third Party: Submit the claim to the primary Third Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer as a co-pay only billing using a valid Other Coverage Code (eg, 8). The patient pay amount will be reduced by up to $75.00 and reimbursement will be received from Therapy First Plus.
Pharmacist instructions for a cash-paying patient: Submit this claim to Therapy First Plus. A valid Other Coverage Code (eg, 1) is required. The patient pay amount will be reduced by up to $75.00 and reimbursement will be received from Therapy First Plus.
Valid Other Coverage Code required: For any questions regarding Therapy First Plus online processing, please call the Help Desk at 1-800-422-5604.