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#ENBREL COPAY CARD ACTIVATION FULL#

Plan Administrators are prohibited from assisting patients with enrollment in the Enbrel Co-Pay Card. Health plans, Specialty pharmacies, and Pharmacy Benefit Managers (individually and collectively “Plan Administrators”) are prohibited from enrolling patients in the Enbrel Co-Pay Card. Your commercial insurance plan may have such limitations, please contact ENBREL ® SupportPlus at 1-88. These programs are often referred to as co-pay maximizer programs. The Enbrel Co-Pay Card also may provide a reduced benefit amount, unilaterally determined by Amgen in its sole discretion, to satisfy the out-of-pocket cost sharing requirement for any patient whose plan or plan agent (including, but not limited to, a Pharmacy Benefit Manager (PBM)) requires enrollment in the Enbrel Co-Pay Card as a condition of the plan or PBM waiving some or all of an otherwise applicable patient out-of-pocket cost sharing amount. If you believe your commercial insurance plan may have such limitations, please contact ENBREL ® SupportPlus at 1-88. These programs are often referred to as accumulator adjustment programs. Patients with these plan limitations are not eligible for the Enbrel Co-Pay Card but may be eligible for other needs-based assistance provided by Amgen. The Enbrel ® Co-Pay Card does not cover out-of-pocket costs for any patient whose selected coverage option under their commercial insurance plan does not apply Enbrel Co-Pay Card payments to satisfy the patient’s co-payment, deductible, or co-insurance for Enbrel. A patient is considered cash-paying where the patient has no insurance coverage for Enbrel or where the patient has commercial or private insurance but Amgen in its sole discretion determines the patient is effectively uninsured because such coverage does not provide a material level of financial assistance for the cost of an Enbrel prescription. It is not valid for cash-paying patients or where prohibited by law. This offer is not valid for patients whose Enbrel prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state programs. There is no income requirement to participate in this program. This program helps eligible patients cover out-of-pocket costs related to Enbrel, up to program limits. *Eligibility Criteria: Subject to program limitations and terms and conditions, theĮnbrel ® Co-Pay Card is open to patients who have an Enbrel prescription and who have commercial or private insurance, including plans available through state and federal healthcare exchanges. Patients are responsible for all amounts that exceed this limit.

Enbrel patients pay $5 out-of-pocket at the first fill and at every refill and Amgen will pay the remaining eligible out-of-pocket costs on behalf of the patient until the Amgen payments have reached either the Maximum Program Benefit and/or the Patient Total Program Benefit.

Please ask your ENBREL ® SupportPlus Representative to help you understand eligibility for the Enbrel Co-Pay Card, whether your particular insurance coverage is likely to result in your reaching the Maximum Program Benefit or your Patient Total Program Benefit amount by calling 1-88 and selecting option 1. Whether you are eligible to receive the Maximum Program Benefit or Patient Total Program Benefit is determined by the type of plan coverage you have. If a patient’s commercial insurance plan imposes different or additional requirements on patients who receive Enbrel Co-Pay Card benefits, Amgen has the right to reduce or eliminate those benefits. The Enbrel Co-Pay Card provides support up to the Maximum Program Benefit or Patient Total Program Benefit. Monthly out-of-pocket costs include co-payment, co-insurance, and deductible out-of-pocket costs.

The Enbrel Co-Pay Card may help lower your Enbrel monthly out-of-pocket costs.

It is not valid for cash paying patients or where prohibited by law.

The program is not valid for patients whose Enbrel prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state programs. The Enbrel Co-Pay Card is open to patients with commercial insurance, regardless of financial need.The following summary is not a substitute for reviewing the Terms and Conditions in their entirety.

#ENBREL COPAY CARD ACTIVATION FULL#

It is important that every patient read and understand the full Enbrel ® Co-Pay Card Terms and Conditions.