You should have a test to check theĮlectrical activity of your heart called an electrocardiogram (ECG) before you take your first dose of MAYZENT.ĭuring the initial updosing period (4 days for the 1-mg daily dose or 5 days for the 2-mg daily dose), MAYZENT can cause your heart rate to slow down, especially after you take your first dose. Slow heart rate (bradycardia or bradyarrhythmia) when you start taking MAYZENT. MAYZENT may cause serious side effects, including: Have certain types of heart block or irregular or abnormal heartbeat (arrhythmia), unless you have a pacemaker This offer is not valid for prescriptions or medicalĪssessments for which payment may be made in whole or in part under a federal or state health care program, including but not limited to Medicare or Medicaid, or for residents of RI. Patients are required to report any benefits they receive under the MAYZENT Medical Co-Pay Program to their insurance company. Medical co-pay support offer is for covered initial assessments/examinations and first-dose observations (FDOs) provided without regard to whether the patient continues on with MAYZENT therapy. The Program includes Medical reimbursement up to $900, after a $125 deductible is paid by the patient. Valid only for those with private insurance. Revoke, or amend the Program and discontinue support at any time without notice. Program is not health insurance, nor is participation a guarantee of insurance coverage. Patients may be asked to re-verify insurance coverage status during the course of the Program. Or state program, or where prohibited by law. Program is not available to patients who are uninsured or whose medications are reimbursed in whole or in part by Medicare, Medicaid, TRICARE, or any other federal Patients will receive their maintenance drug supply each month for up to 12 months or until they receive insurance coverage approval, whichever occurs earlier. Program requires the submission of a request for coverage within 9 months post-Program initiation in order to remain eligible. By participating, patient acknowledges intent to pursue insurance coverage for MAYZENT †Eligible patients must have commercial insurance and a valid prescription for MAYZENT. Novartis reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice. Program may not be combined with any third-party rebate, coupon, or offer. Valid only in the United States and Puerto Rico. Patient is responsible for complying with anyĪpplicable limitations and requirements of their health plan related to the use of the Program. Including any health insurance program or plan, flexible spending account, or health care savings account. Patient may not seek reimbursement for the value received from this Program from other parties, Program is not valid where prohibited by law. Patients and is intended to be credited towards patient out-of-pocket obligations and maximums, including applicable co-payments, coinsurance, andĭeductibles. The value of this Program is exclusively for the benefit of Or (iii) where the patient’s insurance plan reimburses for the entire cost of the drug. Under Medicare, Medicaid, TRICARE, VA, DoD, or any other federal or state health care program, (ii) where patient is not using insurance coverage at all, Patient is responsible for any costs once limit is reached in a calendar year. The Program includes the Co-Pay Card, Payment Card (if applicable), and Rebate, Valid only for those with commercial insurance.
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