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Insulin Product SMS Program Terms & Conditions

Covered insulins:

  • Tresiba® (insulin degludec) injection 100 U/mL, 200 U/mL 
  • NovoLog® (insulin aspart) injection 100 U/mL
  • NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart) injectable suspension 100 U/mL
  • Fiasp® (insulin aspart) injection 100 U/mL

Eligibility and Restrictions:

In order to redeem this offer, patient must have a valid prescription for the brand being filled. A valid Prescriber ID# is required on the prescription. Patient is not eligible if he/she is enrolled in any federal or state health care program with prescription drug coverage, such as Medicaid, Medicare, Medigap, VA, DOD, TRICARE, or any similar federal or state health care program (each a Government Program), or where prohibited by law. Patient must be enrolled in a commercial insurance plan. Offer excludes full cash-paying patients. This offer may not be redeemed for cash. This offer is not valid when the entire cost of your prescription drug is eligible to be reimbursed by a commercial insurance plan or other commercial health or pharmacy benefit programs. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described herein and will not seek reimbursement for any benefit received through this offer. Novo Nordisk’s Eligibility and Restrictions, and Offer Details may change from time to time, and for the most recent version, please visit this webpage. Re-confirmation of information may be requested periodically to ensure accuracy of data and compliance with terms. Patients with questions about the Savings Offer may call 1-833-992-3299.

This offer is valid in the United States, and its territories, unless prohibited by law and may be redeemed at participating retail pharmacies. Availability of the Savings Offer in Massachusetts will be dependent upon state law in effect at the time patient presents the Savings Offer when paying for the covered medications. Void where taxed, restricted, or prohibited by law. This offer is not transferable and is limited to one offer per person. Not valid if reproduced.

Cash Discount Cards and other non-insurance plans are not valid as primary insurance under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. This Savings Offer cannot be combined with any coupon, certificate, voucher, or similar offer.

Patient is responsible for complying with any insurance carrier copayment disclosure requirements, including disclosing any savings received from this program. Novo Nordisk intends that all savings from this offer accrues to the patient. It is illegal to (or offer to) sell, purchase, or trade this offer.

This program is not health insurance. This program is managed by ConnectiveRx on behalf of Novo Nordisk. The parties reserve the right to rescind, revoke, or amend this offer without notice at any time.

Offer Details:

  1. Tresiba® (insulin degludec) injection 100 U/mL, 200 U/mL: As of January 3, 2023 (“Effective Date”) pay as little as (“PALA”) $35 per 30-day, $70 per 60-day, or $105 per 90-day supply, subject to a maximum savings of $65 per 30-day supply, $130 per 60-day supply or $195 per 90-day supply, or pay no more than (“PNMT”) $99 depending on insurance coverage for up to 24 months from date of Savings Offer Activation. If you are commercially insured with drug coverage and your out-of-pocket expense with your commercial insurance is less than or equal to $100 per 30-day supply, you will receive a maximum benefit of $65 per 30-day supply, $130 per 60-day supply or $195 per 90-day supply. If you are commercially insured without drug coverage or your out-of-pocket expense with your commercial insurance is greater than $100 per 30-day supply, you will pay no more than $99 per 35 mL. Offer covers up to 150 mL of medication per calendar month. If you are commercially insured and Tresiba® is not covered, or Tresiba® is covered and your out-of-pocket expense is above $100 per 30-day supply this offer will work outside of your insurance, will not count towards any deductibles, and cannot be applied to a patient’s true out-of-pocket costs.
  2. NovoLog® (insulin aspart) injection 100 U/mL or NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart) injectable suspension 100 U/mL: As of January 3, 2023 (“Effective Date”) pay as little as (“PALA”) $35 per 30-day, $70 per 60-day, or $105 per 90-day supply, subject to a maximum savings of $65 per 30-day supply, $130 per 60-day supply or $195 per 90-day supply, or pay no more than (“PNMT”) $99 depending on insurance coverage for up to 24 months from date of Savings Offer Activation. If you are commercially insured with drug coverage and your out-of-pocket expense with your commercial insurance is less than or equal to $100 per 30-day supply, you will receive a maximum benefit of $65 per 30-day supply, $130 per 60-day supply or $195 per 90-day supply. If you are commercially insured without drug coverage or your out-of-pocket expense with your commercial insurance is greater than $100 per 30-day supply, you will pay no more than $99 per 35mL. Offer covers up to 150 mL of medication per calendar month. If you are commercially insured and Novolog® or Novolog® Mix 70/30 is not covered, or Novolog® or Novolog® Mix 70/30 is covered and your out-of-pocket expense is above $100 per 30-day supply this offer will work outside of your insurance, will not count towards any deductibles, and cannot be applied to a patient’s true out-of-pocket costs.
  3. Fiasp® (insulin aspart) injection 100 U/mL: As of August 8, 2023 (“Effective Date”), pay as little as (“PALA”) $35 per 30-day, $70 per 60-day, or $105 per 90-day supply, subject to a maximum savings of $65 per 30-day supply, $130 per 60-day supply or $195 per 90-day supply, or pay no more than (“PNMT”) $99 depending on insurance coverage for up to 24 months from date of Savings Offer Activation. If you are commercially insured with drug coverage and your out-of-pocket expense with your commercial insurance is less than or equal to $100 per 30-day supply, you will receive a maximum benefit of $65 per 30-day supply, $130 per 60-day supply or $195 per 90-day supply. If you are commercially insured without drug coverage or your out-of-pocket expense with your commercial insurance is greater than $100 per 30-day supply, you will pay no more than $99 per 35mL. Offer covers up to 150 mL of medication per calendar month. If you are commercially insured and Fiasp® is not covered, or Fiasp® is covered and your out-of-pocket expense is above $100 per 30-day supply this offer will work outside of your insurance, will not count towards any deductibles, and cannot be applied to a patient’s true out-of-pocket costs.

Pharmacist:

When you apply this offer, you are certifying that you have not submitted a claim for reimbursement under any Government Program for this prescription, or where prohibited by law. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the eligibility criteria, and terms and conditions described herein. You also certify that you will not seek reimbursement for any benefit received through this offer.

Pharmacist instructions:

  • For commercially insured patients with coverage and an out-of-pocket expense less than or equal to $100 per 30-day supply: Submit the claim to the patient’s primary insurance first, then submit the balance due to SS&C Health as a Secondary Payer as a copay only billing using BIN 019158 and a valid Other Coverage Code 08. The patient is responsible initially for the PALA amount and the offer pays up to the Savings Benefit. Reimbursement will be received from SS&C Health.
  • For commercially insured – not covered patients or where the patient’s out-of-pocket expense is greater than $100 per 30-day supply: Submit the claim to SS&C Health using BIN 019158. A valid Other Coverage Code 01 is required. The patient is responsible for the first $99 per 35 mL (maximum of 150 mL per calendar month) and reimbursement will be received from SS&C Health.
  • For any questions regarding SS&C online processing, please call the Pharmacy Help Desk at 1-844-373-0987.

NOVO NORDISK INSULIN SAVINGS OFFER SMS PROGRAM TERMS

Last Updated January 3, 2023 (effective date)

  1. Agreement Generally: Acceptance. These “Terms of Use” (the “Agreement” or “Terms of Use”) are between you and Novo Nordisk’s Insulin Savings Offer SMS Program (the “Program,” “we,” “us,” or “our”). “You” means you personally. This Agreement sets forth the terms and conditions upon which we make available the Program and its contents and offerings to you. Please note these Terms of Use govern only the Program, and not any other service, program, or website. By participating in the Program, you are agreeing to these Terms of Use. By using the Program, you affirm that you are a US resident, 18 years of age or older, qualify for the Program, and expressly consent to receive communications from Novo Nordisk or its partners in connection with the Program. Your consent to receive marketing messages is not required for the receipt of goods or services from Novo Nordisk. For more information about data use and collection, please read the most recent version of Novo Nordisk’s Privacy Statement https://www.novonordisk-us.com/disclaimer-privacy.html. PLEASE READ THESE TERMS OF USE CAREFULLY, INCLUDING YOUR COMMUNICATION OPTIONS, BEFORE ATTEMPTING TO ENROLL IN THE PROGRAM.
    IF YOU DO NOT AGREE, YOU CANNOT ENROLL IN THE PROGRAM.
  2. Eligibility. To participate in the Program, you must be a resident of the United States and 18 years of age or older and have commercial insurance. Those with any government, state, or federally funded medical or prescription benefit coverage are not eligible for the Program. Novo Nordisk reserves the right to require you to prove that you are at least 18 years of age and your insurance coverage. Eligibility for participation in the Program does not automatically mean that you will get any or all offerings in the Program.
  3. Modifications to Terms of Use. You agree that we may modify these Terms of Use and that such modifications shall become effective immediately upon posting of the modified Terms of Use to our website or otherwise notifying you of an update through one or more components of the Program. If you do not accept the modifications, then you must cease using the Program. The Terms of Use contain the date of posting at the top of the first page. Any revised version of the Terms of Use will only apply to those individuals who sign up for the Program after the effective date. If you have previously signed up for the Program under a prior version of these Terms of Use, you will not be required to adhere to any additions and/or requirements unless you expressly agree.
  4. Permission to Use the Program; Limitations on Use of the Program. Subject to your voluntary acceptance and while you remain in compliance with the Terms of Use, we grant you a limited, revocable, non-exclusive, non-transferable license to use the Program solely and exclusively for your own personal use and not for any other purpose. This license is solely and exclusively for your benefit. All other uses of the Program are prohibited.
  5. Communication Options. By choosing to enroll in the Program, you consent/opt into the option of receiving text messages from the Program. After you complete your initial enrollment in the Program by phone, you will receive a welcome text to complete your enrollment process and to further opt-in to your preferred method of communication with the Program. We do not guarantee that the Program communications will be received and are not responsible for lost or misdirected communications.
    To get additional Program support, text “HELP” to 97430 or call 1-833-992-3299. To opt-out of receiving text messages from Novo Nordisk or its partners related to the Program, text “STOP” to 97430 or call 1-800-727-6500.
    If you opt out of the Program, any future data collection in the Program from you will end. Any data previously collected through the Program may be stored by Novo Nordisk. PLEASE NOTE that opting out of the Program does not unsubscribe and/or opt you out of any future communications from Novo Nordisk or its partners that you may have previously signed up for separate and apart from the Program. You may separately opt out of all marketing communications from Novo Nordisk, by simply clicking the “Unsubscribe” link within any email you receive from Novo Nordisk or its partners, or by calling 800-727-6500, or clicking here, or by sending Novo Nordisk a letter containing your name, email address, and phone number, to Novo Nordisk, 800 Scudders Mill Road, Plainsboro, New Jersey 08536.
  6. Text Messaging. If you choose to communicate in the Program by text message, the following terms apply:
    1. Text Message Frequency. The Program’s message frequency varies. Please be aware that Novo Nordisk brands and services may have separate text messaging programs. The total number of text messages you receive from Novo Nordisk or its partners, therefore, may vary based on the number of Novo Nordisk text messaging programs for which you sign-up to receive messages.
    2. Cost. You will not be charged any fee from Novo Nordisk or its partners in connection with the Program. However, Novo Nordisk encourages you to check with your mobile service provider to see what other message and data rates may apply, including any applicable roaming charges. Novo Nordisk is not responsible for any fees or charges from any carrier or service provider related to Program communications.
    3. Supported Carriers. The following US carriers are supported:
      1. Major Carriers: AT&T, Verizon Wireless, Sprint, and T-Mobile USA.
      2. Minor Carriers: Aio Wireless, Alaska Communications Systems (ACS), Appalachian Wireless (EKN), Bluegrass Cellular, Boost Mobile, Carolina West Wireless, CellCom, Cellular One of East Central IL (ECIT), Cellular One of Northeast Arizona, Cellular One of Northeast Pennsylvania, Chariton Valley Cellular, Cricket, Coral Wireless (MobiPCS), Cross, C-Spire (CellSouth), Duet IP (Maximum Communications New Core Wireless), Element Mobile (Flat Wireless), Epic Touch (Elkhart Telephone), GCI, Golden State, Google Voice, Hawkeye (Chat Mobility), Hawkeye (NW Missouri), Illinois Valley Cellular, Inland Cellular, iWireless (Iowa Wireless), Keystone Wireless (Immix Wireless/PC Man), Metro PCS, Mosaic (Consolidated or CTC Telecom), MTA Communications, MTPCS (Cellular One Nation), Nex-Tech Wireless, Panhandle Communications, Peoples Wireless, Pine Cellular, Pioneer, RINA, Sagebrush Cellular (Nemont), SI Wireless/Mobile Nation, Simmetry (TMP Corporation), SouthernLinc, SRT Wireless, Thumb Cellular, Union Wireless, United Wireless, U.S. Cellular, Viaero Wireless, Virgin Mobile, and West Central (WCC or 5 Star Wireless).
    4. Your Mobile Telephone Number. You represent that you are the account holder or authorized user for the mobile telephone number you opt-in to receive text messages for the Program.
    5. Access or Delivery to Mobile Network Is Not Guaranteed. Delivery of information and content to a mobile device is not guaranteed and may fail to due to a variety of circumstances or conditions. Alerts sent via text message may not be delivered if the mobile phone is not in range of a transmission site, or if sufficient network capacity is not available at a particular time. Even within a coverage area, factors beyond the control of the wireless carrier may interfere with message delivery, including the customer's equipment, terrain, proximity to buildings, foliage, and weather. Novo Nordisk will not be held responsible for any delays in the receipt of any text messages as delivery is subject to effective transmission from your mobile service provider or network operator. You understand and acknowledge that network services, including but not limited to mobile network services, are outside of Novo Nordisk’s control, and Novo Nordisk is not responsible or liable for issues arising from them. Note that there may be data or message fees imposed by your carrier or service provider if you choose to receive text messages from the Program.
  7. Privacy. In order to enroll in the Program, you may provide us with your phone number. We require this information in order to communicate with you, provide you with the Program, and to send you Program materials. Your information will be shared between Novo Nordisk and its service providers who support the Program in accordance with applicable laws. Novo Nordisk and its service providers may share information that does not individually identify you without restriction in accordance with applicable laws. Novo Nordisk understands and values the importance of your privacy. In accordance with these Terms of Use, Novo Nordisk may use your information for program improvements, quality monitoring, data and analytics for Novo Nordisk commercial purposes, and future Novo Nordisk marketing communications (including branded or unbranded emails, text messages, or direct mail). For more information on how we collect and use your information, please read our full Privacy Statement https://www.novonordisk-us.com/disclaimer-privacy.html.
  8. Security. By enrolling in the Program, you understand that Novo Nordisk is not a “Covered Entity” or “Business Associate” under the Health Information Privacy Rule (or “HIPAA”) that requires protection of a patient’s confidential information. By releasing my personal information to Novo Nordisk, you acknowledge that this information will not be protected by HIPAA but will be protected by reasonable security measures.
  9. Content. All information available in or provided through the Program is collectively referred to in these Terms as the “Content.” The Content may include savings card information along with refill reminders. You may not sell, give, reproduce, create derivative works of, publicly display, or otherwise distribute the Content to anyone other than your physician(s) or caregiver(s). All rights not expressly granted herein are reserved. Novo Nordisk assumes no responsibility for the accuracy or appropriateness of any information provided by you through the Program.
  10. NOT MEDICAL ADVICE. This Program does not substitute medical advice from your health care provider. You will have to contact him or her directly about issues, questions, or concerns. The Program may provide you with communications related to savings card eligibility, enrollment, and refill reminders. The Program does not give medical advice. OUR CONTENT AND COMMUNICATIONS ARE NOT INTENDED TO BE A REPLACEMENT OR SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. THE CONTENT AND COMMUNICATIONS DO NOT CONSTITUTE MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. YOU ACKNOWLEDGE AND UNDERSTAND THAT YOU WILL SEEK THE ADVICE OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER WITH ANY QUESTIONS THAT ARISE REGARDING ANY MEDICAL CONDITION. YOU ACKNOWLEDGE THAT ALL INFORMATION AND GUIDANCE PROVIDED BY YOU IS SOLELY AT YOUR OWN RISK. You understand that Novo Nordisk does not endorse any particular physician or health care provider for the treatment of any specific medical condition. You further understand that this program is not a means to communicate product issues or negative side effects to Novo Nordisk. You are encouraged to report negative side effects of prescription drugs to the FDA at www.fda.gov/medwatch, or by phone at 1-800-FDA-1088. Novo Nordisk is not responsible for monitoring or recording text messages that may constitute an issue or negative side effect. However, if you are using a Novo Nordisk Product as treatment, and some of your entered responses can be interpreted as a side effect of the medication, Novo Nordisk reserves the right to contact you for more information by phone or written communication. For additional information about your medication, please call Novo Nordisk Customer Care at 1-833-693-6742.
  11. Prohibited Activity. You will not: (a) access or attempt to access the Program or any part thereof that you are not authorized to access or through any means that you are not authorized to use; (b) disrupt or interfere with the security of, or otherwise cause harm to the Program, systems, resources, accounts, passwords, servers or networks connected to or accessible through the Program or any affiliated or linked websites or access or use the Program in any manner that could damage, disable, overburden, or impair any server or network used by us in connection with the Program; (c) use the Program to transmit any information of a sensitive nature, such as health information, social security numbers, credit card numbers (other than, as strictly allowed), or any other information that, if generally exposed, could lead to identity theft, financial fraud, embarrassment, or other harm; (d) use the Program in any manner that infringes upon or violates any intellectual property rights or other rights or interest of any party or otherwise constitutes pornography, defamation, harassment, bullying, predatory behavior, false and deceptive advertising, or hate speech; (e) submit any software, programs, or files via the Program that are harmful or disruptive of another’s equipment, software, or other property, including any corrupted files, time bombs, Trojan Horses, viruses, and worms; (f) disrupt, interfere with, or inhibit any other user from using and enjoying the Program; (g) violate any applicable laws or regulations related to the access to or use of the Program, and/or engage in any activity prohibited by the Terms of Use; (h) compile, use, download, or otherwise copy any materials available on the Program (except as expressly permitted), or transmit, provide, or otherwise distribute (whether or not for a fee) such materials to any third party; (i) use, or allow anyone else to use, any robot, spider, or other such programmatic or automatic device, including but not limited to automated dial-in or inquiry devices, to obtain information from the Site or otherwise monitor or copy any portion of the Program; (j) frame, mirror, or use framing techniques on any part of the Program without our express prior written consent; (k) make any use of, or allow anyone else to make any use of, data extraction, scraping, mining, or other data gathering tools, or create a database by systematically downloading or storing the Program, or any portion thereof, or otherwise scrape, collect, store, or use the Program, except pursuant to the limited license granted by the Terms of Use; (l) modify, adapt, translate, reverse engineer, decompile, or disassemble any portion of the Program; or (m) remove any copyright, trademark, or other proprietary rights notice from the Program. These examples of prohibited conduct are illustrative and are not exhaustive.
    TO THE MAXIMUM EXTENT AUTHORIZED BY LAW WE RESERVE THE RIGHT, BUT DISCLAIM ANY OBLIGATION WHATSOEVER, TO MONITOR OUR SITE AND YOUR COMPLIANCE WITH THIS SECTION AND WITH THE TERMS OF USE AS A WHOLE.
  12. Termination of the Program. Novo Nordisk may suspend or terminate your use of the Program if Novo Nordisk believes you are in breach of these Terms of Use. Your receipt of Program communications is also subject to termination in the event that your telephone or network service terminates or lapses. Novo Nordisk reserves the right to modify or discontinue, temporarily or permanently, all or any part of the Program with or without notice. You assume sole responsibility for the proper use and scheduling of any medications, treatments, and procedures related to your health care and disease management.
  13. Assignment. You may not assign any of your rights or obligations hereunder, whether by operation of law or otherwise, without our prior written consent. Notwithstanding the foregoing, we may freely assign the Terms of Use, and the rights and obligations therein, without your consent, including but not limited to, in connection with a merger, acquisition, corporate reorganization, or sale of all or substantially all of our assets. Subject to the foregoing, the Terms of Use shall bind and inure to the benefit of the parties, their respective successors and permitted assigns.
  14. Entire Agreement. This Agreement, including the documents incorporated herein by reference, is the entire understanding and agreement between the Program and you with respect to the subject matter hereof.
  15. Miscellaneous. The invalidity or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision. To the event that any provision of this Agreement is found to be invalid or unenforceable, this Agreement shall be construed in accordance with its terms as if the invalid or unenforceable provision was not contained therein. No delay or failure by the Program to enforce any provision of this Agreement shall be a waiver of any of our rights under this Agreement.