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LO LOESTRIN® FE SAVINGS PROGRAM
Program Terms, Conditions and Eligibility Criteria:
This offer is good for use only with a valid prescription for Lo Loestrin® Fe (norethindrone acetate and ethinyl estradiol tablets, ethinyl estradiol tablets and ferrous fumarate tablets) at the time the prescription is filled by the pharmacist and dispensed to the patient.
Depending on your insurance coverage, eligible patients may pay as little as $25 for each of up to thirteen (13) one-month prescription fills OR each of up to four (4) three-month prescription fills. Check with your pharmacist for your copay discount. Maximum savings limits apply; patient out-of-pocket expense will vary.
This offer is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this offer if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This offer is not valid for cash-paying patients.
Each card is valid for up to thirteen (13) prescription fills of a 28-day supply each OR up to four (4) prescription fills of an 84-day supply each. Offer applies only to prescriptions filled before the program expires on 12/31/20.
Allergan reserves the right to rescind, revoke, or amend this offer without notice.
Offer good only in the USA, including Puerto Rico, at participating retail pharmacies.
Void if prohibited by law, taxed, or restricted.
This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law.
This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription.
This offer is not health insurance.
This card expires December 31, 2020.
By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer.
For questions about the program, including savings on mail order prescriptions, please call 1.855.439.2817 1.855.439.2817.
Pharmacist Instructions for a Patient with an Eligible Third-party Payer:
When you redeem this card, you certify that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other government programs for this prescription. Submit the claim to the primary Third-party Payer first, then submit the balance due to Change Healthcare using BIN #004682 as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code (eg, 8). If you receive a rejection due to PA, step-edit, or NDC block, submit Other Coverage Code of 03 (Secondary Claim). The patient’s out-of-pocket expense will be reduced up to the maximum savings limit for the program. Reimbursement will be received from Change Healthcare. For any questions regarding Change Healthcare online processing, call Allergan Savings Program Navigator at 1.800.769.3161.1.800.769.3161.
Program managed by ConnectiveRx on behalf of Allergan.
LO LOESTRIN® FE SAVINGS PROGRAM
Program Terms, Conditions and Eligibility Criteria:
This offer is good for use only with a valid prescription for Lo Loestrin® Fe (norethindrone acetate and ethinyl estradiol tablets, ethinyl estradiol tablets and ferrous fumarate tablets) at the time the prescription is filled by the pharmacist and dispensed to the patient.
Depending on your insurance coverage, eligible patients may pay as little as $25 for each of up to thirteen (13) one-month prescription fills OR each of up to four (4) three-month prescription fills. Check with your pharmacist for your copay discount. Maximum savings limits apply; patient out-of-pocket expense will vary.
This offer is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this offer if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This offer is not valid for cash-paying patients.
Each card is valid for up to thirteen (13) prescription fills of a 28-day supply each OR up to four (4) prescription fills of an 84-day supply each. Offer applies only to prescriptions filled before the program expires on 12/31/20.
Allergan reserves the right to rescind, revoke, or amend this offer without notice.
Offer good only in the USA, including Puerto Rico, at participating retail pharmacies.
Void if prohibited by law, taxed, or restricted.
This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law.
This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription.
This offer is not health insurance.
This card expires December 31, 2020.
By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer.
For questions about the program, including savings on mail order prescriptions, please call 1.855.439.2817 1.855.439.2817.
Pharmacist Instructions for a Patient with an Eligible Third-party Payer:
When you redeem this card, you certify that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other government programs for this prescription. Submit the claim to the primary Third-party Payer first, then submit the balance due to Change Healthcare using BIN #004682 as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code (eg, 8). If you receive a rejection due to PA, step-edit, or NDC block, submit Other Coverage Code of 03 (Secondary Claim). The patient’s out-of-pocket expense will be reduced up to the maximum savings limit for the program. Reimbursement will be received from Change Healthcare. For any questions regarding Change Healthcare online processing, call Allergan Savings Program Navigator at 1.800.769.3161.1.800.769.3161.
Program managed by ConnectiveRx on behalf of Allergan.
DR. LAKEISHA RICHARDSON, Board-Certified OB/GYN and paid consultant of AbbVie, shares her insight on contraception and the various options available to women when it comes to preventing pregnancy
Did you know?
If you start taking the pill on any day other than the first day of your period, you will need to use back-up contraception, like condoms and spermicide, for the first seven days.
Did you know?
Source: Online survey conducted by Harris Poll on behalf of Allergan, between July 7-14, 2014, among 1005 U.S. women aged 18-45 currently using oral contraceptives (OCs) or considering use in the next 6 months.
*Survey respondents could choose from the following to indicate their level of worry about the amount of hormones they are exposed to through the use of OCs: extremely worried, very worried, somewhat worried, and not at all worried. The 78% value represents those who answered extremely worried, very worried, and somewhat worried.
†Survey respondents could choose from the following to indicate their interest in an OC with the lowest amount of daily estrogen: extremely interested, very interested, somewhat interested, and not at all interested. The 93% value represents those who answered extremely interested, very interested, and somewhat interested.
Did you know?
Did you know?
THE PILL DOES NOT PROTECT
AGAINST STDS
Hear us out: The Pill doesn't protect against any sexually transmitted diseases (STDs), including HIV infection (AIDS). Condoms can. Using condoms in conjunction with the Pill is a good habit to help prevent both pregnancy and STDs.
Did you know?
Schedule an appointment: Your healthcare provider can be a helpful resource.
Get informed: The Pill is a great option for many women, but it may not be for everyone. You can learn about your birth control options by speaking with your healthcare provider to find an option that may be right for you.
Did you know?
If you start taking the pill on any day other than the first day of your period, you will need to use back-up contraception, like condoms and spermicide, for the first seven days.
Did you know?
Did you know?
78%
of women worry about the amount of hormones they are exposed to through the use of pills*
Source: Online survey conducted by Harris Poll on behalf of Allergan, between July 7-14, 2014, among 1005 U.S. women aged 18-45 currently using oral contraceptives (OCs) or considering use in the next 6 months.
*Survey respondents could choose from the following to indicate their level of worry about the amount of hormones they are exposed to through the use of OCs: extremely worried, very worried, somewhat worried, and not at all worried. The 78% value represents those who answered extremely worried, very worried, and somewhat worried.
Did you know?
93%
are interested in a pill with the lowest
amount of daily estrogen†
Source: Online survey conducted by Harris Poll on behalf of Allergan, between July 7-14, 2014, among 1005 U.S. women aged 18-45 currently using oral contraceptives (OCs) or considering use in the next 6 months.
†Survey respondents could choose from the following to indicate their interest in an OC with the lowest amount of daily estrogen: extremely interested, very interested, somewhat interested, and not at all interested. The 93% value represents those who answered extremely interested, very interested, and somewhat interested.
Did you know?
Take your pill at the same time,
every day
Refill your pill pack on or before
the last day of your current pack
Did you know?
THE PILL DOES NOT PROTECT
AGAINST STDS
Hear us out: The Pill doesn't protect against any sexually transmitted diseases (STDs), including HIV infection (AIDS). Condoms can. Using condoms in conjunction with the Pill is a good habit to help prevent both pregnancy and STDs.
Did you know?
Schedule an appointment: Your healthcare provider can be a helpful resource.
Get informed: The Pill is a great option for many women, but it may not be for everyone. You can learn about your birth control options by speaking with your healthcare provider to find an option that may be right for you.
Lo Loestrin Fe is a prescription birth control pill used for the prevention of pregnancy. If you are moderately obese, discuss with your healthcare provider whether Lo Loestrin Fe is appropriate for you.
Do not use Lo Loestrin Fe if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from birth control pills, including death from heart attack, blood clots, or stroke. This risk increases with age and the number of cigarettes you smoke.
Do not use Lo Loestrin Fe if you have or have had blood clots, history of heart attack or stroke, high blood pressure that medicine cannot control, breast cancer or any cancer that is sensitive to female hormones, liver disease or liver tumors, unexplained bleeding from the vagina, if you are or may be pregnant, or if you take Hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, as this may increase levels of liver enzymes in the blood.
Treatment with Lo Loestrin Fe should be stopped if you have a blood clot, and at least 4 weeks before and through 2 weeks after major surgery. You should not take Lo Loestrin Fe any earlier than 4 weeks after having a baby, or if you are breastfeeding. If you experience yellowing of the skin or eyes due to problems with your liver, you should stop taking Lo Loestrin Fe. If you are pre-diabetic or diabetic, your doctor should monitor you while using Lo Loestrin Fe. Your doctor should evaluate you if you have any significant change in headaches or irregular menstrual bleeding.
Lo Loestrin Fe increases the risk of serious conditions including blood clots, stroke, and heart attack. These can be life-threatening or lead to permanent disability.
The most common side effects reported by women taking Lo Loestrin Fe in a study were nausea/vomiting, headache, spotting or bleeding between menstrual periods, painful menstruation, weight change, breast tenderness, acne, abdominal pain, anxiety, and depression.
Birth control pills do not protect you against any sexually transmitted disease, including HIV, the virus that causes AIDS.
Please see the full Prescribing Information, including Boxed Warning, and Patient Information. Please see the full Prescribing Information, including Boxed Warning, and Patient Information.
*Depending on insurance coverage, eligible patients may pay as little as $25 for each of up to 13 one-month prescription
fills OR each of up to 4 three-month prescription fills. Check with your pharmacist for your copay discount. Maximum
savings limit applies; patient out-of-pocket expense will vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs.
Please click here for Program Terms, Conditions, and Eligibility Criteria.
Do not use Lo Loestrin Fe if you smoke cigarettes and are over 35 years old. Smoking increases your risk of serious cardiovascular side effects (heart and blood vessel problems) from birth control pills, including death from heart attack, blood clots, or stroke. This risk increases with age and the number of cigarettes you smoke.
Lo Loestrin Fe (norethindrone acetate and ethinyl estradiol tablets, ethinyl estradiol tablets and ferrous fumarate tablets) is a prescription birth control pill used for the prevention of pregnancy. If you are moderately obese, discuss with your healthcare provider whether Lo Loestrin Fe is appropriate for you.
Do not use Lo Loestrin Fe if you have or have had blood clots, history of heart attack or stroke, high blood pressure that medicine cannot control, breast cancer or any cancer that is sensitive to female hormones, liver disease or liver tumors, unexplained bleeding from the vagina, if you are or may be pregnant, or if you take Hepatitis C drugs containing ombitasvir/paritaprevir/ritonavir, with or without dasabuvir, as this may increase levels of liver enzymes in the blood.
Treatment with Lo Loestrin Fe should be stopped if you have a blood clot, and at least 4 weeks before and through 2 weeks after major surgery. You should not take Lo Loestrin Fe any earlier than 4 weeks after having a baby, or if you are breastfeeding. If you experience yellowing of the skin or eyes due to problems with your liver, you should stop taking Lo Loestrin Fe. If you are pre-diabetic or diabetic, your doctor should monitor you while using Lo Loestrin Fe. Your doctor should evaluate you if you have any significant change in headaches or irregular menstrual bleeding.
Lo Loestrin Fe increases the risk of serious conditions including blood clots, stroke, and heart attack. These can be life-threatening or lead to permanent disability.
The most common side effects reported by women taking Lo Loestrin Fe in a study were nausea/vomiting, headache, spotting or bleeding between menstrual periods, painful menstruation, weight change, breast tenderness, acne, abdominal pain, anxiety, and depression.
Birth control pills do not protect you against any sexually transmitted disease, including HIV, the virus that causes AIDS.
Please see the full Prescribing Information, including Boxed Warning, and Patient Information.