You must be 18 years of age or older to use this card. The selling, purchasing, trading, or counterfeiting of this card is prohibited by the law. Subject to additional terms and conditions, which can be found Original card must be presented to the pharmacist at the time the prescription is filled. Offer void where prohibited by law and subject to change or discontinue without notice. This offer is invalid for Patients without commercial drug insurance or whose prescription claims for Emgality 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. Ensure your healthcare provider submits a Prior Authorization form to your insurance company with your prescription. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. Patients that have commercial drug insurance but do not have coverage for Emgality may be able to pay as little as $0 for their first fill of a 30-day supply of Emgality.
EMGALITY COPAY CARD PLUS
Offer subject to a monthly cap of wholesale acquisition cost plus usual and customary pharmacy charges and a separate annual cap of $4,900. Patients that have commercial drug insurance coverage for Emgality may be able to pay as little as $0 for a 30-day supply of Emgality. Offer good for up to 12 months of Emgality from Patient qualification into the program. This offer is for eligible, commercially insured patients only. Ensure your healthcare provider submits a Prior Authorization form to your insurance company with your prescription. Simply download and present the Savings Card to the pharmacist when you pick up your Emgality prescription for cluster headache at your local pharmacy. Pay as little as $0 for up to 12 months with the Emgality Savings Card *
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