![]() Information pertaining to your use of the Program will be shared with Emmaus, the sponsor of the Program, and its affiliates.As part of this application, Patient must attest to financial need and insurance coverage. Patient must complete an application for Copay Assistance in order for Emmaus to determine patient eligibility for the program.Both patient and pharmacist are each individually responsible for reporting receipt of Program benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the Program, as required. Patient, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer.Void where prohibited by law, taxed, or restricted. Patients who begin receiving prescription benefits from such Government Programs at any time will no longer be eligible to use the Program. Medicare Part D enrollees who are in the prescription drug coverage gap (the "donut hole") are not eligible for the Program. Patients without insurance coverage are considered "cash-pay" patients.Or by commercial plans or other health or pharmacy benefit programs that reimburse for the entire cost of prescription drugs.In whole or part, by Medicare, Medicaid or a Medicare part D plan, TRICARE, VA, DOD, Puerto Rico government health insurance plan, or any other federal or state-funded healthcare benefit program (collectively, "Government Programs").The Program is valid only for patients with commercial insurance and is not valid for prescriptions that are eligible to be reimbursed:.The Program is not insurance and is not intended to substitute for insurance. ![]() Acceptance in this Program is not conditioned on any past, present, or future purpose, including additional doses. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. ![]() This Program is available for each valid prescription. The Program is limited to one per person and is not transferable.You must be 18 years or older to use the Program for yourself or a minor. Product must originate in the U.S., Puerto Rico, or U.S. territories at participating eligible Network Pharmacies who are unable to afford the out-of-pocket costs associated with their ENDARI prescription. The Endari Commercial Copayment Assistance Program ("Program") can be used only by eligible residents of the U.S., Puerto Rico, or U.S. ![]()
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