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*Eligibility Requirements:

This offer cannot be used if you are a beneficiary of, or any part of your prescription is covered by: (1) any federal or state healthcare program (Medicare, Medicaid, TriCARE, etc.), including a state pharmaceutical assistance program, (2) the Medicare Prescription Drug Program (Part D), or if you are currently in the coverage gap, or (3) insurance that is paying the entire cost of the prescription.


Terms and Conditions:

You must meet Eligibility Requirements. You agree to report your use of this offer to any Third Party that reimburses you or pays for any part of the prescription price. Use of this offer is confirmation that you are permitted, under the terms and conditions of the health benefit plan(s) covering your prescriptions, to take advantage of co-pay coverage programs. You additionally agree that you will not submit the cost of any portion of the product dispensed pursuant to this offer to a federal or state healthcare program for purposes of counting it toward your out-of-pocket expenses. The amount of this offer is not to exceed $15 or your co-pay amount, whichever is less. This coupon is not valid with any other program, discount, or incentive involving ULORIC. Offer expires 03/31/2015. This offer may be rescinded, revoked, or amended without notice. No reproductions. This offer is void where prohibited by law, taxed, or restricted. Limit one offer per purchase. Cash value of 1/100 of 1¢. For questions about this offer, call the Customer Service Center at 1-866-279-5630.

Savings

With the ULORIC Savings Card, eligible patients will pay no more than $15, subject to a maximum benefit of $75, for ULORIC prescriptions and each refill until March 31, 2015. Along with these savings, you will also be enrolled in our GoutSmart program where you will receive helpful tips and information about managing your gout.

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