†Terms and Conditions
By using the Humatrope Co-pay Card (“Card”), you attest that you meet the eligibility criteria, agree to and will comply with the terms and conditions described below: Offer expires on 12/31/2020 and subject to $2400 annual cap plus usual and customary pharmacy charges. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. Offer void where prohibited by law. This offer is invalid for patients without commercial drug insurance or those whose prescription claims for Humatrope are eligible to be reimbursed, in whole or in part, by any governmental program, including, without limitation, Medicaid, Medicare, Medicare Part D, Medigap, DOD, VA, TRICARE/CHAMPUS, or any State Patient or Pharmaceutical Assistance Program. If you live in Massachusetts, the Card expires on the earlier of: (i) the expiration date of this Card (12/31/2020); (ii) the date an AB rated generic equivalent becomes available; or (iii) 12/31/2020 absent a change in Massachusetts state law. If you live in California, the Card expires on the earlier of: (i) the expiration date of this Card (12/31/2020) or (ii) the date an FDA-approved therapeutically equivalent for Humatrope or over-the-counter product with the same active ingredients becomes available. Available only in the US and Puerto Rico for residents of the US and Puerto Rico. By accepting this offer, you agree that if you are required to do so under the terms of your insurance coverage for this prescription or are otherwise required to do so by law, you should notify your insurance carrier of your redemption of this Card. This offer cannot be combined or utilized with any other program, discount, discount card, cash discount card, coupon, incentive, or similar offer involving Humatrope. It is prohibited for any person to sell, purchase or trade; or to offer to sell, purchase or trade, or to counterfeit this Card. This offer may be terminated, rescinded, revoked or amended by Lilly USA, LLC at any time without notice. Card activation required. This Card is not health insurance. This Card expires on 12/31/2020.
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