Terms and ConditionsTERMS AND CONDITIONS The coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost. The coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions. The coupon is valid for up to a one-month’s supply of either tablets or oral pellets per prescription fill. The coupon may be redeemed only once every 21 days. No other purchase is necessary. The coupon is not transferable. No substitutions are permitted. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. The coupon is not insurance. Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”). Subject to changes in state law, the coupon may become invalid for residents of Massachusetts prior to its expiration date. You must be 18 years of age or older to redeem the coupon. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient 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 residents of the United States or the Commonwealth of Puerto Rico 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 the 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. Expiration Date: 08/31/2026. Close818508/31/2026 false2166PREVYMIS610524Loyalty5077818517960507779605077796061052412/31/2023<ul> <li>The coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost.</li> <li>The coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions.</li> <li>The coupon is valid for up to a one-month’s supply per prescription fill. The coupon may be redeemed only once every 21 days.</li> <li>No other purchase is necessary.</li> <li>The coupon is not transferable. No substitutions are permitted. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.</li> <li><strong><strong>The coupon is not insurance.</strong></strong></li> <li><strong>Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).</strong></li> <li><strong><strong>Subject to changes in state law, the coupon may become invalid for residents of Massachusetts prior to its expiration date.</strong></strong></li> <li>You must be 18 years of age or older to redeem the coupon. Patient, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer. Patient 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.</li> <li>The coupon can be used only by eligible residents of the United States or the Commonwealth of Puerto Rico 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.</li> <li>The coupon is the property of Merck and must be turned in on request.</li> <li><strong>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.</strong></li> <li>Merck reserves the right to rescind, revoke, or amend the offer at any time without notice.</li> <li>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.</li> <li><strong>Expiration Date: 5/31/2025.</strong></li> </ul> 0px100%center<span style=”color:#185C5C”>HERE IS YOUR <b>COUPON</b>. PLEASE PRINT OR SAVE THE IMAGE.</span>true1rem2rem#185C5Cwhiteblack center <strong>Eligible, privately insured patients may pay as little as $15 per prescription on each of up to 8 qualifying prescriptions for up to a one-month’s supply per prescription. Maximum savings is $2,500 per prescription.</strong> 1.5rem1.1remtruefalse#c05824centertrue<strong>NOT VALID FOR PATIENTS WHO ARE UNINSURED OR PATIENTS WITH MEDICARE OR OTHER GOVERNMENT PROGRAM INSURANCE.</strong>1.2rem1.5remblack#159a95h6centerThis coupon is not insurance.PREVYMIS is a prescription medication. Only your health care provider can decide whether PREVYMIS is right for you.25px20pxblackwhitebody-two-column50%50%body-three-sectionHow this coupon works:.75rem#c05c2ewhite<ul> <li><strong>This coupon can be used up to 8 times before the expiration date for up to a one-month’s supply of either tablets or oral pellets per qualifying prescription. Savings are limited to the amount of your out-of-pocket cost over $15, up to a total of $2,500 per prescription. This coupon may be redeemed only once every 21 days.</strong></li> <li>Present this activated coupon and your insurance card with a valid signed prescription at any participating eligible retail or mail-order pharmacy (certain restrictions apply).</li> <li>If you are unable to redeem this coupon at your eligible retail or mail-order pharmacy, please keep your receipt and call McKesson Corporation at 877‑264‑2454 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.</li> <li>If you lose this coupon, please visit prevymis.com to obtain a replacement coupon. Regardless of the number of replacement coupons received, this coupon offer is limited to 8 prescriptions of PREVYMIS per patient before the expiration date.</li> <li>Not all patients are eligible to use this coupon. <span class=”” style=”color:#000″><strong>Please see Terms and Conditions.</strong></span></li> </ul>.63remtrue <span class=”” style=”color:#000;line-height:14px; padding:2px;”><strong>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 Web site. Regardless of how many coupons you receive or print, you may only use the coupon consistent with the Terms and Conditions.</strong></span>.5575remblack<span>Prescriber:</span>.75rem#c05c2ewhite<span>To initiate a coupon for an appropriate patient to use up to 8 times, you should:</span> <ul> <li><span class=””><strong>Read the Prescribing Information before prescribing PREVYMIS.</strong></span> For copies of the Prescribing Information, call 800-672-6372, visit prevymis.com, or contact your Merck representative.</li> <li>Write a prescription for PREVYMIS. No substitutions are permitted.</li> <li>Give the valid signed prescription and this coupon to the patient along with the Patient Information for PREVYMIS.</li> <li>Eligible patients can take or send this coupon and the signed prescription to any participating eligible retail or mail-order pharmacy to receive savings on their out-of-pocket cost (savings will vary depending on their out-of-pocket cost).</li> <li>Not all patients are eligible to use this coupon. <span class=”extraBold” style=”color:#000″><strong>Please see Terms and Conditions.</span></strong></li> </ul>.63remfalsePharmacist:.75rem#c05c2ewhite<ul> <li>This coupon is valid only when accompanied by a prescription for PREVYMIS. Coupon value is limited to $2,500 or patient’s actual out-of-pocket cost over $15, whichever is less. This coupon is valid for up to a one-month’s supply per prescription fill. This coupon may be redeemed only once every 21 days. <strong>Please review Terms and Conditions on this coupon for important eligibility restrictions.</strong></li> <li><strong>Submit transaction to McKesson Corporation using Rx BIN No. 610524. For pharmacy processing questions, please call the McKesson Help Desk at 877-264-2454 (8 AM-8 PM ET, Monday-Friday).</strong></li> <li>Input coupon information, including RxBIN, RxPCN, RxGrp, and ID No., as secondary coverage and transmit using the Coordination of Benefits (COB) segment of the National Council for Prescription Drug Programs (NCPDP) transaction. Applicable discounts will be displayed in the transaction response.</li> <li>Uninsured, cash-paying patients are not eligible to use this coupon. For privately insured patients without coverage for PREVYMIS, you agree to charge no more than the usual and customary retail price (subject to restrictions set by McKesson). For any other prescriptions, please use the patient’s primary method of payment and a new Rx number. Please clear the COB secondary screen after processing the transaction.</li> <li>Acceptance of this coupon and your submission of claims are subject to the Terms and Conditions, posted at www.mckesson.com/mprstnc, and the Terms and Conditions of this coupon.</li> <li>By processing this coupon, you agree that PREVYMIS was dispensed pursuant to this coupon and that you will not submit a claim for reimbursement to any Government Program (as that term is defined in the Terms and Conditions).</li> </ul>.63remfalsetrue<ul> <li>Subject to changes in state law, this coupon may become invalid for residents of Massachusetts prior to its expiration date.</li> <li>You agree to notify the patient’s insurance carrier of this coupon redemption, as may be required by the terms and conditions of your relationship with the insurance carrier.</li> <li>This coupon may not be applied toward any other pharmacy purchase.</li> <li>McKesson Corporation reserves the right to audit and review all records and documentation relating to the redemption of this coupon and the dispensing of product.</li> <li><strong>Please note: Coupon must be activated prior to the date of purchase of the prescription. Ensure the date of prescription fill matches the date the patient is actually purchasing the prescription.</strong> </li> </ul>.63remfalse<ul> <li>The coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost.</li> <li>The coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions.</li> <li>The coupon is valid for up to a one-month’s supply of either tablets or oral pellets per prescription fill. The coupon may be redeemed only once every 21 days.</li> <li>No other purchase is necessary.</li> <li>The coupon is not transferable. No substitutions are permitted. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.</li> <li><strong><strong>The coupon is not insurance.</strong></strong></li> <li><strong>Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).</strong></li> <li><strong><strong>Subject to changes in state law, the coupon may become invalid for residents of Massachusetts prior to its expiration date.</strong></strong></li> <li>You must be 18 years of age or older to redeem the coupon. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient 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.</li> <li>The coupon can be used only by eligible residents of the United States or the Commonwealth of Puerto Rico 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.</li> <li>The coupon is the property of Merck and must be turned in on request.</li> <li><strong>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.</strong></li> <li>Merck reserves the right to rescind, revoke, or amend the offer at any time without notice.</li> <li>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.</li> <li><strong>Expiration Date: 08/31/2026.</strong></li> </ul> .75rem.63remblack#2ba1980rem14pxCopyright © 2024 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved. US-CYT-01857 07/24true<ul> <li>This coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost.</li> <li>This coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions.</li> <li>This coupon is valid for up to a one-month’s supply of either tablets or oral pellets per prescription fill. This coupon may be redeemed only once every 21 days.</li> <li>No other purchase is necessary.</li> <li>This coupon is not transferable. No substitutions are permitted. This offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer.</li> <li><strong><strong>This coupon is not insurance.</strong></strong></li> <li><strong>Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).</strong></li> <li><strong><strong>Subject to changes in state law, this coupon may become invalid for residents of Massachusetts prior to its expiration date.</strong></strong></li> <li>You must be 18 years of age or older to redeem this coupon. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient through this 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 this coupon, as may be required.</li> <li>This coupon can be used only by eligible residents of the United States or the Commonwealth of Puerto Rico 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.</li> <li>This coupon is the property of Merck and must be turned in on request.</li> <li><strong>It is illegal to sell, purchase, trade, or counterfeit, or offer to sell, purchase, trade, or counterfeit this coupon. Void if reproduced. Void where prohibited by law, taxed, or restricted.</strong></li> <li>Merck reserves the right to rescind, revoke, or amend this offer at any time without notice.</li> <li>Data related to your redemption of this 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.</li> <li><strong>Expiration Date: 08/31/2026.</strong></li> </ul> Get the Coupon for PREVYMIS.Eligible, privately insured patients may pay as little as $15 per prescription on each of up to 8 qualifying prescriptions for up to a one-month’s supply per prescription. Maximum savings is $2,500 per prescription.* *Not all patients are eligible. Terms and Conditions apply. Step 1Step 2Step 3Step 4Step 1Step 1: Current StepLet’s get started by checking if you are eligible for the coupon for PREVYMIS.Did you lose the coupon you already activated? Replace it here. Please enter the following information exactly as it appears on the insurance card. The information you enter is captured by McKesson, a third-party service provider of the program, on behalf of Merck to determine eligibility. The information you share will not be accessible by Merck. Privacy Notice | McKesson* Required fieldFirst name*Please enter a valid First nameLast name*Please enter a valid Last nameBirth date*ZIP code*Please enter a valid five-digit zip codeEmail (optional)Please enter a valid email addressNextAre you the parent or guardian of the patient?YesNoNextNote: The coupon can only be used if you activate it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Get the Coupon for PREVYMIS.Step 1Step 2Step 3Step 4Step 2Step 2: Current StepDo you have health insurance?YesNoNextDo you have state-, federal-, or government-funded insurance, such as Medicaid, Medicare, TRICARE, or Puerto Rico Government Health Insurance Plan?Government Insurance includes: Patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).See more types of plans hereYesNoNextNextEnter your prescription insurance information:Example prescription insurance card:The placement of the information on your card may be different. Not all cards have an RxPCN.Prescription InsuranceCompany Name[ NAME ]RxBIN: XXXXXXID Number:RxPCN: XXXXXXXXXXXXXXXXXXXXXXRxGrp: XXXXXXXXXXGROUP: XXXXXXXXXCustomer Service: XXX-XXX-XXXXNot sure what this means?RxBIN (6 numbers) *Please enter a valid RxBIN with 6 numbers.RxGrp (up to 15 letters and/or numbers) *Please enter a valid RxGrp number.RxPCN, if your card has it (up to 10 letters and/or numbers) *Please enter a valid RxPCN number.NextNeed help? Call 877-264-2454We’re sorry, but patients enrolled in state-, federal-, or government-funded health insurance are not eligible for a coupon.Back to PREVYMIS HomeNeed help? Call 877-264-2454We’re sorry, but you must have private health insurance in order to be eligible for a coupon.Back to PREVYMIS HomeNeed help? Call 877-264-2454Get the Coupon for PREVYMIS.Step 1Step 2Step 3Step 4Step 3Step 4: Current StepPlease review the Terms and Conditions.To continue, please scroll to read through all Terms and Conditions.TERMS AND CONDITIONS The coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost. The coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions. The coupon is valid for up to a one-month’s supply of either tablets or oral pellets per prescription fill. The coupon may be redeemed only once every 21 days. No other purchase is necessary. The coupon is not transferable. No substitutions are permitted. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. The coupon is not insurance. Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”). Subject to changes in state law, the coupon may become invalid for residents of Massachusetts prior to its expiration date. You must be 18 years of age or older to redeem the coupon. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient 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 residents of the United States or the Commonwealth of Puerto Rico 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 the 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. Expiration Date: 08/31/2026. Click “Accept” to confirm you agree to the Terms and Conditions. By accepting, you understand you will no longer be eligible to use the coupon if you become uninsured, begin to have Government Program insurance (as defined above), or your insurance company or state stops allowing patients to use the coupon. You confirm that your insurance company has not prohibited the use of coupons.AcceptNeed help? Call 877-264-2454Get the Coupon for PREVYMIS.Step 1Step 2Step 3Step 4Step 4Step 4: Current StepYou are eligible for the coupon for PREVYMIS!How would you like to receive your coupon?Select all that apply.EmailText*PrintYou’ll be able to print your coupon after you click submit.Email me coupon reminders and patient supportYou can unsubscribe within the email or call 877-264-2454 at any time.Please enter a valid email addressText me coupon reminders and patient supportAt any time, you can opt-out of the text messaging program by texting STOP to 98678*Please enter a valid numberUnless you change your selection sooner, your authorization will expire upon the expiration or termination of the coupon. By entering your information above and clicking Submit: 1) You are agreeing to receive communications, including by autodialer if applicable, regarding coupon reminders, which may also include related patient support, from the administrator(s) of this program on behalf of Merck; 2) You are agreeing to have the information you have provided as well as information obtained about the use of your coupon shared with the administrator(s) of this program on behalf of Merck.*Message and data rates may apply. Message frequency varies. Text HELP for information. See Terms and Conditions.To access the McKesson privacy policy, please click here.SubmitNo thanks, go back to PREVYMIS homeNeed help? Call 877-264-2454Thank you! We’ve texted your coupon to [XXX-XXX-XXXX].To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase. Need help? Call 877-264-2454Thank you! We’ve emailed your coupon to [username@domain.com].To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you! We’ve texted your coupon to [XXX-XXX-XXXX] and we’ve emailed your coupon to [username@domain.com].To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you!To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454We are unable to continue the activation process based on the information entered.Need help? Call 877-264-2454Get the Coupon for PREVYMIS. Eligible, privately insured patients may pay as little as $15 per prescription on each of up to 8 qualifying prescriptions for up to a one-month’s supply per prescription. Maximum savings is $2,500 per prescription.* *Not all patients are eligible. Terms and Conditions apply.It looks like you’ve already activated a coupon for PREVYMIS. Do you need to replace a lost coupon that has already been activated?YesNoNextNeed help? Call 877-264-2454Did you misplace your coupon for PREVYMIS?Step 1Step 2Step 1Step 1: Current StepStep 1Please enter your information to receive a copy of your coupon.As a reminder, your coupon for PREVYMIS is valid for use 8 times only. If you have not already used your coupon 8 times but have misplaced it, please enter your information below to receive an additional copy of your coupon.Please enter the following patient information exactly as it appears on the insurance card. The information you enter is captured by McKesson, a third-party service provider of the program on behalf of Merck to determine eligibility. The information you share will not be accessible by Merck.Privacy Notice | McKessonFirst namePlease enter a valid First nameLast namePlease enter a valid Last nameBirth dateANDZIP codePlease enter a valid five-digit zip codeORCoupon ID NextNote: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Did you misplace your coupon for PREVYMIS?Step 1Step 2Step 2Step 2: Current StepWe found your information in our records. How would you like to receive your replacement coupon?Select all that apply.EmailText*PrintYou’ll be able to print your coupon after you click submit.Email me coupon reminders and patient supportYou can unsubscribe within the email or call 877-264-2454 at any time.Please enter a valid email addressText me coupon reminders and patient supportAt any time, you can opt-out of the text messaging program by texting STOP to 98678*Please enter a valid numberUnless you change your selection sooner, your authorization will expire upon the expiration or termination of the coupon. By entering your information above and clicking Submit: 1) You are agreeing to receive communications, including by autodialer if applicable, regarding coupon reminders, which may also include related patient support, from the administrator(s) of this program on behalf of Merck; 2) You are agreeing to have the information you have provided as well as information obtained about the use of your coupon shared with the administrator(s) of this program on behalf of Merck.*Message and data rates may apply. Message frequency varies. Text HELP for information. See Terms and Conditions.To access the McKesson privacy policy, please click here.SubmitNo thanks, go back to PREVYMIS home Need help? Call 877-264-2454Thank you for replacing your coupon for PREVYMIS! We’ve texted your coupon to [XXX-XXX-XXXX].As a reminder, your coupon for PREVYMIS is valid for use 8 times only. The number of times you are able to use the copy of your coupon depends on the number of times you have already used your coupon. To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you for replacing your coupon for PREVYMIS! We’ve emailed your coupon to [username@domain.com].As a reminder, your coupon for PREVYMIS is valid for use 8 times only. The number of times you are able to use the copy of your coupon depends on the number of times you have already used your coupon. To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup. Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you for replacing your coupon for PREVYMIS! We’ve texted your coupon to [XXX-XXX-XXXX] and we’ve emailed your coupon to [username@domain.com].As a reminder, your coupon for PREVYMIS is valid for use 8 times only. The number of times you are able to use the copy of your coupon depends on the number of times you have already used your coupon. To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup. Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you for replacing your coupon for PREVYMIS!As a reminder, your coupon for PREVYMIS is valid for use 8 times only. The number of times you are able to use the copy of your coupon depends on the number of times you have already used your coupon. To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup. Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454We are unable to continue the activation process based on the information entered.Need help? Call 877-264-2454We’re sorry, but we did not find an existing coupon belonging to a patient with that name, date of birth, and zip code or coupon identification number.Get the coupon for PREVYMISEntered the wrong information? Try againNeed help? Call 877-264-2454Activate the coupon for PREVYMIS.Step 1Step 2Step 3Step 4Step 1Step 1: Current StepLet’s get started by checking if you are eligible for the coupon for PREVYMIS.What’s your coupon ID number?Example savings card:The placement of the information on your card may be different. Not all cards have an RxPCN.RxBIN: XXXXXXRxGRP: XXXXXXXXXXRxPCN: XXXXXXIssuer: XXXXXID Number: XXXXXXXXX Expiration Date: XX/XX/XXXXWhat’s this?Please enter the following information exactly as it appears on the insurance card. The information you enter is captured by McKesson, a third-party service provider of the program, on behalf of Merck to determine eligibility. The information you share will not be accessible by Merck.Privacy Notice | McKesson* Required fieldFirst name*Please enter a valid Last nameLast name*Please enter a valid Last nameBirth date*ZIP code*Please enter a valid five-digit zip codeEmail (optional)Please enter a valid email addressNextAre you the parent or guardian of the patient?YesNoNextNote: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454 Activate the coupon for PREVYMIS. Step 1Step 2Step 3Step 4Step 2Step 1: Current StepDo you have health insurance?YesNoNextDo you have state-, federal-, or government-funded insurance, such as Medicaid, Medicare, TRICARE, or Puerto Rico Government Health Insurance Plan?Government Insurance includes: Patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”).See more types of plans hereYesNoEnter your prescription insurance information:Example savings card:The placement of the information on your card may be different. Not all cards have an RxPCN.Prescription InsuranceCompany Name[ NAME ]RxBIN: XXXXXXID NumberRxPCN: XXXXXXXXXXXXXXXXXXRxGrp: XXXXXXXXXXGROUP: XXXXXXXXXCustomer Service: XXX-XXX-XXXXNot sure what this means?RxBIN (6 numbers) *Please enter a valid RxBIN with 6 numbers.RxGrp (up to 15 letters and/or numbers) *Please enter a valid RxGrp number.RxPCN, if your card has it (up to 10 letters and/or numbers) *Please enter a valid RxPCN number.NextNextNextNeed help? Call 877-264-2454We’re sorry, but patients enrolled in state-, federal-, or government-funded health insurance are not eligible for a coupon.Back to PREVYMIS HomeNeed help? Call 877-264-2454We’re sorry, but you must have private health insurance in order to be eligible for a coupon.Back to PREVYMIS HomeNeed help? Call 877-264-2454Activate the coupon for PREVYMIS.Step 1Step 2Step 3Step 4Step 3Step 2: Current StepPlease review the Terms and Conditions.To continue, please scroll to read through all Terms and Conditions.TERMS AND CONDITIONS The coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost. The coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions. The coupon is valid for up to a one-month’s supply of either tablets or oral pellets per prescription fill. The coupon may be redeemed only once every 21 days. No other purchase is necessary. The coupon is not transferable. No substitutions are permitted. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. The coupon is not insurance. Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”). Subject to changes in state law, the coupon may become invalid for residents of Massachusetts prior to its expiration date. You must be 18 years of age or older to redeem the coupon. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient 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 residents of the United States or the Commonwealth of Puerto Rico 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 the 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. Expiration Date: 08/31/2026. Click “Accept” to confirm you agree to the Terms and Conditions. By accepting, you understand you will no longer be eligible to use the coupon if you become uninsured, begin to have Government Program insurance (as defined above), or your insurance company or state stops allowing patients to use the coupon. You confirm that your insurance company has not prohibited the use of coupons.AcceptNeed help? Call 877-264-2454Activate the coupon for PREVYMIS.Step 1Step 2Step 3Step 4Step 4Step 3: Current StepYour coupon has been activated. You can take it to the pharmacy, including the Pharmacist Instructions and Terms and Conditions, with your valid prescription.You also have the option to text or email a copy of the coupon.Select all that apply.EmailText*Email me coupon reminders and patient supportYou can unsubscribe within the email or call 877-264-2454 at any time.Please enter a valid email addressText me coupon reminders and patient supportAt any time, you can opt-out of the text messaging program by texting STOP to 98678*Please enter a valid Number Unless you change your selection sooner, your authorization will expire upon the expiration or termination of the coupon. By entering your information above and clicking Submit: 1) You are agreeing to receive communications, including by autodialer if applicable, regarding coupon reminders, which may also include related patient support, from the administrator(s) of this program on behalf of Merck; 2) You are agreeing to have the information you have provided as well as information obtained about the use of your coupon shared with the administrator(s) of this program on behalf of Merck.*Message and data rates may apply. Message frequency varies. Text HELP for information. See Terms and Conditions.To access the McKesson privacy policy, please click here.SubmitNo thanks, go back to PREVYMIS homeNeed help? Call 877-264-2454Thank you! We’ve texted your coupon to [XXX-XXX-XXXX].To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you! We’ve emailed your coupon to [username@domain.com].To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you! We’ve texted your coupon to [XXX-XXX-XXXX] and we’ve emailed your coupon to [username@domain.com].To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454Thank you!To use this coupon, please show it, including the Pharmacist Instructions and Terms and Conditions, to the pharmacist with your valid prescription at pickup.Note: The coupon can only be used if you activated it prior to filling your prescription. It cannot be used with a previous prescription purchase.Need help? Call 877-264-2454We are unable to continue the activation process based on the information entered……….Need help? Call 877-264-2454We’re sorry, but you must be 18 years or older to get a coupon.Need help? Call 877-264-2454We’re sorry, but you must be 18 years or older to get a coupon.Need help? Call 877-264-2454 To print a PDF and access the actual coupon on your mobile device, please ensure that the ‘Blocks Pop-ups’ functionality is disabled.OK
TERMS AND CONDITIONS The coupon is valid for up to $2,500 off your out-of-pocket cost on each of up to 8 qualifying prescriptions for PREVYMIS. Patient is responsible for the first $15 of their out-of-pocket cost. The coupon is valid for use 8 times only. Patient must have a co-payment (or, if privately insured without coverage for PREVYMIS, make full cash payment) for the prescription. Savings are limited to amount of your out-of-pocket cost over $15, up to a maximum of $2,500 per prescription for up to 8 qualifying prescriptions. The coupon is valid for up to a one-month’s supply of either tablets or oral pellets per prescription fill. The coupon may be redeemed only once every 21 days. No other purchase is necessary. The coupon is not transferable. No substitutions are permitted. The offer cannot be combined with any other coupon, free trial, discount, prescription savings card, or other offer. The coupon is not insurance. Patient must have private insurance. Not valid for uninsured patients or patients covered under Medicaid (including Medicaid patients enrolled in a qualified health plan purchased through a health insurance exchange [marketplace] established by a state government or the federal government), 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”), or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program (collectively, “Government Programs”). Subject to changes in state law, the coupon may become invalid for residents of Massachusetts prior to its expiration date. You must be 18 years of age or older to redeem the coupon. Patient, guardian, pharmacist, and prescriber agree not to seek reimbursement for all or any part of the benefit received by the patient 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 residents of the United States or the Commonwealth of Puerto Rico 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 the 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. Expiration Date: 08/31/2026.
