Synthroid co-pay card
terms and conditions

TO THE PATIENT:

Present this card to your pharmacist along with your commercial insurance card and a valid prescription to reduce your amount due. This page serves as an activated co-pay savings card. For questions, or if your pharmacy does not accept this card, please call OPUS Health at 1.800.364.4767.

PHARMACIST INSTRUCTIONS:

Please submit the co-pay card authorized for all commercially insured patients by the patient’s primary insurance as a secondary transaction to OPUS Health. When you use this card, you are confirming that you have not submitted and will not submit a claim for this prescription for reimbursement under any federal, state or government-funded healthcare program, such as Medicare (including Part D), Medicare Advantage, Medicaid, Medigap, Veterans Affairs, the Department of Defense or TRICARE. Pharmacists with questions please call the OPUS Health Pharmacy Help Desk at 1.800.364.4767.

This card is the property of AbbVie Inc. and must be surrendered upon demand. Eligibility: Available to patients with commercial insurance coverage for SYNTHROID who meet eligibility criteria. Co-pay assistance program is not available to patients receiving reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the SYNTHROID Co-pay Savings Card and patient must call 1.866.627.4980 to stop participation. Patients residing in or receiving treatment in certain states may not be eligible. Patients may not seek reimbursement for value received from the SYNTHROID Co-pay Savings Program from any third-party payers. Offer subject to change or discontinuation without notice. Restrictions, including monthly maximums, may apply. Subject to all other terms and conditions, the maximum monthly benefit that may be available solely for the patient’s benefit under the co-pay assistance program is $15.00 per month during the calendar year for patients receiving SYNTHROID every month or $25.00 per month during the calendar year for patients receiving SYNTHROID every 3 months. The actual application and use of the benefit available under the co-pay assistance program may vary on a monthly, quarterly, and/or annual basis, depending on each individual patient’s plan of insurance and other prescription drug costs. This assistance offer is not health insurance. By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer. To learn about AbbVie’s privacy practices and your privacy choices, visit https://privacy.abbvie