Interested in Savings?
With a Lo Loestrin® Fe Savings Card, eligible patients may
pay as little as $25* per one‑month prescription fill or three‑month
prescription fill of Lo Loestrin Fe.
How the program works
|
1.
|
Before visiting your pharmacy, you must activate your card. Visit loloestrinfesavings.com or call 1.877.395.8433. |
|
2.
|
Once activated, your card is good for up to 13 one-month prescription fills OR each of up to 4 three-month prescription fills before the program expires on June 30, 2018. |
|
3.
|
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. |
|
4.
|
If your primary insurance rejects for prior authorization, step edit, or NDC block, you may still be considered eligible for this program. If you are eligible,* your pharmacist can continue to process the secondary transaction so you can receive your discount. |
|
5.
|
Be sure to bring your Lo Loestrin Fe Savings Card to the pharmacy each time you fill your Lo Loestrin Fe prescription. |
* Depending on insurance coverage, eligible patients may pay as little as $25* for each of up to 13 one-month Lo Loestrin® Fe prescription fills OR each of up to 4 three‑month Lo Loestrin® Fe prescription fills. Check with your pharmacist for your copay discount. Maximum savings limits apply; patient out‑of‑pocket expense will vary. Offer not valid for patients enrolled in Medicare, Medicaid, or other federal or state healthcare programs. Please see back of card or click here for Program Terms, Conditions, and Eligibility Criteria.
Mail-order patients
If you fill your prescription through a mail-order pharmacy, or if you are unable to have your card processed at your local pharmacy, please submit:
|
1.
|
A photocopy of the front and back of your Lo Loestrin® Fe Savings Card |
|
2.
|
Your original proof of purchase (original pharmacy receipt with your name and address, pharmacy name, product name, prescription number, NDC number, date filled, quantity, and price) and a photocopy of the front and back of your insurance card |
|
3.
|
Your date of birth |
|
4.
|
Mail all of the information to: Lo Loestrin® Fe Savings Program, c/o ConnectiveRx, PO Box 2355, Morristown, NJ 07962 |
Please allow 6-8 weeks to receive your reimbursement. Reimbursement requests must be postmarked by June 30, 2018. Reimbursements are subject to Program Terms, Conditions, and Eligibility Criteria.
Questions?
If you are an eligible patient* and unable to receive your benefit at the pharmacy, or have any questions regarding the Lo Loestrin® Fe Savings Program, PLEASE DO NOT call your healthcare provider. Instead, please call us at 1.855.439.2817, and we will be happy to assist you.
