Terms and Conditions | LIPITOR® (atorvastatin calcium) Safety Info

Terms and Conditions

Choose the LIPITOR program you are registered for to see the Terms and Conditions.

LIPITOR CHOICE CARD TERMS AND CONDITIONS

By using the LIPITOR Choice Card (the "Card"), you attest that you meet the eligibility criteria and will comply with the Terms and Conditions described below:

You will pay $4 for a 30-day supply (30 tablets) if: you use commercial/private insurance and your out-of-pocket expense for a 30-day supply of name-brand LIPITOR is $130 or less.

You will pay $30 for a 30-day supply (30 tablets) if: you do not use prescription health coverage to purchase your name-brand LIPITOR under this program or you use commercial/private insurance and your out-of-pocket expense for a 30-day supply of name-brand LIPITOR is $130 or more. In addition:

  1. a) Medicare Part D and Affordable Care Act (ACA) Exchange patients may participate in this Card Program, but cannot use any part of their Medicare Part D or ACA Exchange prescription benefit for LIPITOR during the term of this offer.
  2. b) Out-of-pocket expenditures under this Card Program cannot be applied towards a patient’s Medicare Part D true out of pocket (TrOOP) or ACA Exchange expenses.
  3. c) Patients participating in this category cannot seek reimbursement for a purchase of LIPITOR from any third party insurance entity during the term of this offer.

This offer is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as "La Reforma de Salud"]).

For all eligible patients, you can only qualify for up to $2500 of savings per calendar year. After a maximum of $2500, you will pay usual monthly out-of-pocket costs.

This Card cannot be combined with any other rebate/coupon, free trial, discount, prescription savings card, or similar offer for the specified prescription.

The Card will be accepted only at participating pharmacies.

This Card is not health insurance.

Offer valid only in the U.S. and Puerto Rico, but not for Massachusetts residents or where otherwise prohibited by law.

The Card is limited to 1 use per person per month during this offering period and is not transferable. It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit this Card.

Pfizer reserves the right to rescind, revoke or amend the Card Program without notice at any time.

You must be 18 or older to participate in this Program.

Card Program expires December 31, 2015.

No membership fees.

For reimbursement when using mail order, mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date and amount circled to:

LIPITOR Choice Card
14001 Weston Parkway, Suite 103
Cary, NC 27513-9967

Be sure to include a copy of the front of your Choice Card, your name and mailing address.

LIPITOR $4 CO-PAY CARD TERMS AND CONDITIONS

By using the LIPITOR $4 Co-Pay Card (the “Card”), you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:

This Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma de Salud”]).

The Card is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs that reimburse you for the entire cost of your prescription drugs.

To qualify for this offer, your out-of-pocket expense must be greater than $4 per prescription. If your out-of-pocket expense for a 1-month supply (30 tablets) is $104 or less, you will pay $4 for a 1-month supply. If your out-of-pocket expense for a 1-month supply (30 tablets) exceeds $104, you qualify for up to $100 in savings for a 1-month supply. In either case, you can only qualify for up to $1500 of savings per calendar year. After a maximum of $1500, you will pay usual monthly out-of-pocket costs.

You must deduct the value received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf.

The Card is not valid for Massachusetts residents whose prescriptions are covered in whole or in part by third-party insurance, or where otherwise prohibited by law.

This Card cannot be combined with any other rebate/coupon, free trial, or similar offer for the specified prescription.

The Card will be accepted only at participating pharmacies.

This Card is not health insurance.

Offer good only in the United States and Puerto Rico.

The Card is limited to 1 per person during this offering period and is not transferable. Offer limited to 1 use per month.

Pfizer reserves the right to rescind, revoke, or amend the program without notice at any time.

Card and Program expire 12/31/2014.

No membership fees.

For reimbursement when using a nonparticipating pharmacy/mail order: Pay for LIPITOR prescription and mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date, and amount circled to:

LIPITOR Co-Pay Card
14001 Weston Parkway, Suite 103
Cary, NC 27513-9967

Be sure to include a copy of the front of your Co-Pay Card, your name, and your mailing address.

LIPITOR 30 FOR $30 TERMS AND CONDITIONS

By using the LIPITOR 30 for $30 Card (the "Card"), you attest that you meet the eligibility criteria and will comply with the terms and conditions described below:

  • No health insurance is accepted in combination with this offer.
  • Patients participating in this Card program (“Card Program”) may not seek reimbursement for a purchase of LIPITOR from any 3rd party insurance entity during the term of this offer.
  • Medicare patients may participate in this Card Program, but may not use any part of their Medicare Part D prescription benefit for LIPITOR during the term of this offer.
  • Out-of-pocket expenditures under this Card Program cannot be applied towards a patient’s Medicare Part D true out of pocket (TrOOP) expenses.
  • Except as outlined above with respect to Medicare patients, this Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as "La Reforma de Salud"]).
  • To qualify for this offer, a patient’s out-of-pocket expenses for LIPITOR must be greater than $30 per prescription. If a patient’s out-of-pocket expenses for a 1-month supply (30 tablets) are greater than $30, the patient will only pay $30.
  • This Card cannot be combined with any other rebate/coupon, free trial, discount, prescription savings card, or similar offer for the specified prescription.
  • The Card will be accepted only at participating pharmacies.
  • This Card is not health insurance.
  • Offer valid only in the U.S. and Puerto Rico, but not for Massachusetts residents or where otherwise prohibited by law.
  • The Card is limited to 1 use per person per month during this offering period and is not transferable. It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit this Card.
  • Pfizer reserves the right to rescind, revoke or amend the Card Program without notice at any time.
  • A patient must be 18 or older to participate in this Program.
  • Card Program expires 12/31/2014.

For reimbursement when using mail order, mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date and amount circled to:

LIPITOR 30 for $30 Card
14001 Weston Parkway, Suite 103
Cary, NC 27513-9967

Be sure to include a copy of the front of your Card, your name and mailing address.

No membership fees.