Current ELIGIBILITY
PATIENT INFORMATION

Eligibility For Your Patients

Eligibility
Patient information

Step 1
Step 2

Required Field

Is the patient a United States Resident?

Yes

Does the patient currently have commercial insurance for a portion of the prescription drug cost?

Yes

Is the patient enrolled in any federal or state subsidized healthcare program that covers a portion of their prescription drug costs, including Medicare (such as Medicare Part D prescription drug benefit), Medicaid, TRICARE, or any other federal or state healthcare plan, including pharmaceutical assistance programs?

Yes

* By activating the KERENDIA Savings Card, your patient agrees to the following statements:

Your patient’s information above is true and correct
Your patient is not enrolled in a federal- or state-funded prescription drug benefit program, such as Medicare or Medicaid, or any private indemnity or HMO insurance that reimburses your patient the entire cost of your prescription drug
You agree that your patient is not Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees
Should your patient begin receiving prescription benefits from one of these types of programs at any time, your patient will no longer participate in this savings program.

Your patient agrees to the information above and accepts the Program Terms, Conditions, and Eligibility Criteria

KERENDIA Savings Card Terms & Conditions

Patient must meet the eligibility requirements of the KERENDIA Savings Card; for example, only commercially insured patients are eligible
Patient must inform the KERENDIA Savings Card of change in insurance status
It is required that the patient understand, accept, and meet the terms of all the KERENDIA Savings Card requirements
Use of the KERENDIA Savings Card must be consistent with and not prohibited by the requirements of the patient’s health insurance
The KERENDIA Savings Card benefit has a max of $3,000, per patient
The KERENDIA Savings Card is for commercially insured patients using KERENDIA for an approved FDA indication
The KERENDIA Savings Card does not cover costs for charges associated with patient visits
Offer valid only for patients treated in the USA, including Puerto Rico, Guam and US Territories
Bayer reserves the right to determine eligibility, monitor participation, equitably distribute product and modify or discontinue the KERENDIA Savings Card at any time with or without notice
Patient agrees to provide necessary health information to the administrators of the KERENDIA Savings Card

For questions about the KERENDIA Savings Program, please call us at 888-KERENDIA (537-3634).

Eligibility For Your Patients

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Eligibility For Your Patients