Eligibility Requirements
By using the Humulin R U-500 Savings Card, you attest that you meet the eligibility criteria, agree to and will comply with the terms and conditions described below:
Offer good until December 31, 2021 for up to 12 prescription fills with a maximum of 2 vials per fill or up to 7 packs of the U-500 KwikPen® per fill. Patient must have commercial drug insurance coverage for Humulin R U-500 to pay as little as $25 per fill, subject to a maximum annual cap of $8,400. Offer void where prohibited by law. Patient is responsible for any applicable taxes, fees, or amounts exceeding monthly or annual caps. This offer is invalid for patients without commercial drug insurance or whose prescription claims for Humulin R U-500 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. This offer is not valid for: Massachusetts residents if an AB-rated generic equivalent is available; California residents if an FDA-approved therapeutic equivalent is 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 Humulin R U-500. 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 This offer may be terminated, rescinded, revoked, or amended by Lilly USA, LLC at any time without notice.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 12/31/2021.