Learn how your patients can save on Horizant^®

Horizant^® Co-Pay Savings Card

Patient: Eligible commercially insured patients may receive their first prescription of Horizant^® 600 mg or 300 mg for as little as $0. For questions regarding your eligibility or benefits or if you wish to discontinue your participation, call 1-855-700-2990 (8 ᴀᴍ–8 ᴘᴍ ET, Monday–Friday).

Any patient may opt to take advantage of Azurity’s cash-payment programs; patients must attest the claim is not being billed through insurance.

Pharmacist: Benefit limitations apply. When you use this card, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, other governmental programs, or drug discount card for this prescription. By redeeming this coupon, you agree that you understand and will abide by the terms and conditions of this offer, posted at www.mckesson.com/mprstnc. Submit transaction to McKesson Corporation using BIN #610524.

Co-Pay Program Terms and Conditions:

• The patient must have a valid prescription for Horizant^®
• The program is not valid for prescriptions that are eligible for reimbursement, in whole or in part by Medicaid, Medicare, or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma De Salud”]).
• This program is not valid for prescriptions that are eligible for reimbursement by private insurance plans or other health or pharmacy benefit programs that reimburse you for the entire cost of your prescription drugs.
• Each patient is limited to one active co-pay offer at a time during this offer period and the co-pay assistance offer is not transferable.
• The program cannot be combined with any other rebate, coupon, free trial, or similar offer for the specified prescription.
• The Co-pay Program is not health insurance.
• This offer is good only in the United States and Puerto Rico as allowed by law.
• Offer valid until the end of the current calendar year.
• Azurity reserves the right to rescind, revoke, or amend co-pay assistance without notice.
• For questions regarding the Co-pay assistance, please call the Help Desk at 1-855-700-2990

For questions regarding setup, claim transmission, patient eligibility, or other issues, call 1-855-700-2990 (8 ᴀᴍ–8 ᴘᴍ ET, Monday–Friday).