This coupon is not insurance.
DULERA is a prescription medication. Only your healthcare provider can decide if DULERA is right for you.
If eligible, follow these steps to save up to $20 off on each of up to 6 qualifying prescriptions for DULERA.
- If your doctor thinks that DULERA is right for you, he or she will write a prescription for DULERA.
- To activate the coupon, go to https://www.activatethecard.com/6573 or call 855-208-3358.
- Print the coupon.
- Present the coupon and your insurance card (if any) with a valid signed prescription at any participating eligible retail or mail-order pharmacy (certain restrictions apply).
- If you are unable to redeem the coupon at your eligible retail or mail-order pharmacy, please keep your receipt and call McKesson Corporation at 855-208-3358 within 30 days of purchase to request a Direct Member Reimbursement (DMR) form. Please Note: Not all patients will be eligible for Direct Member Reimbursement. Merck may discontinue Direct Member Reimbursement at any time without notice.
- The coupon can be used up to 6 times before the expiration date and provides a maximum benefit of up to $20 or the amount of your out-of-pocket cost, whichever is less, off on each of up to 6 qualifying prescriptions (regardless of the quantity supplied on the prescription).
- Not all patients are eligible to use the coupon. Please see Coupon Terms and Conditions.
Please Note: The same coupon offer may be available in different forms. For example, you may receive the coupon from your doctor, or you may print it yourself from the product website. Regardless of how many coupons you receive or print, you may only use the coupon and receive up to $20 off an eligible prescription, up to 6 times before the expiration date printed on the coupon.
Coupon Terms and Conditions:
- The coupon is valid for up to $20 off on each of up to 6 qualifying prescriptions for DULERA (regardless of the quantity supplied on the prescription).
- Coupon is valid for use 6 times only. Patient must have a copayment or make full cash payment for the prescription. Savings are limited to amount of your out-of-pocket cost, up to a maximum of $20 per prescription for up to 6 qualifying prescriptions.
- No other purchase is necessary.
- The coupon is not transferable. No substitutions are permitted. Cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.
- The coupon is not insurance.
- The coupon is valid for patients with private insurance or cash-paying patients. Not valid for patients covered under Medicaid, Medicare, a Medicare Part D or Medicare Advantage plan (regardless of whether a specific prescription is covered), TRICARE, CHAMPUS, Puerto Rico Government Health Insurance Plan ("Healthcare Reform"), any qualified health plan purchased through a health insurance exchange established by a state government or the federal government, or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, "Government Programs").
- You must be 18 years of age or older to redeem the coupon for yourself or minor (other age restrictions may apply). Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the recipient through the offer. Patient or guardian is responsible for reporting receipt of coupon benefit to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the coupon, as may be required.
- The coupon can be used only by eligible United States or Commonwealth of Puerto Rico residents at participating eligible retail or mail-order pharmacies in the United States or the Commonwealth of Puerto Rico. Product must originate in the United States or the Commonwealth of Puerto Rico.
- The coupon is the property of Merck and must be turned in on request.
- It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit the coupon. Void if reproduced. Void where prohibited by law, taxed, or restricted.
- Merck reserves the right to rescind, revoke, or amend this offer at any time without notice.
- Data related to your redemption of the coupon may be collected, analyzed, and shared with Merck, for market research and other purposes related to assessing coupon programs. Data shared with Merck will be aggregated and de-identified, meaning it will be combined with data related to other coupon redemptions and will not identify you.
- Please read the Medication Guide for DULERA, including the information about asthma-related death, and discuss it with your doctor. The physician Prescribing Information also is available.
- Expiration Date: 07/31/2014.