OPENINGS® savings card
The OPENINGS® savings card is provided by Alcon. The savings card provides savings on out‑of‑pocket expenses for up to a 90‑day supply of TRAVATAN Z® Solution, SIMBRINZA® Suspension and/or AZOPT® Suspension, as described below. Prescriptions for more than one Alcon product (TRAVATAN Z® Solution, SIMBRINZA® Suspension or AZOPT® Suspension) are not required. If you have valid prescriptions for more than one product, the copay expense and savings apply to each product. You may use the savings card once every 30, 60, or 90 days, depending on when you last received a 30‑, 60‑, or 90‑day supply of each Alcon product. Use of the savings card does not obligate you to use or to continue using any Alcon product. You may use the savings card at any participating pharmacy located in the United States.
The OPENINGS® savings card may not be combined with any savings, discount, free trial, or other similar offer for the same prescription. The savings card is not transferable and is void if reproduced. The savings card is not health insurance. Limit 1 savings card per patient. The OPENINGS® savings card has no cash value and will not be accepted outside of participating pharmacies in the United States. Please visit Alcon’s website for our privacy practices. Alcon reserves the right to revoke or amend this offer without notice at any time and to deny payment for noncompliance with the terms of this offer. This offer expires December 31, 2014, unless this offer is earlier terminated by Alcon.
This offer may be subject to limitations imposed by state or federal law, or by your health insurer. The OPENINGS® savings card is not valid where prohibited by law or by your health insurer.
By using the OPENINGS® savings card, you acknowledge that you currently meet the following eligibility criteria:
You have a valid prescription for TRAVATAN Z® Solution, SIMBRINZA® Suspension, or AZOPT® Suspension;
Minimum out-of-pocket expenses and maximum coverage amounts
Patients are responsible for paying out-of-pocket expenses noted below and any amount that exceeds the Alcon payment for each prescription, as follows:
TRAVATAN Z® Solution is available in 2.5 mL and 5 mL, SIMBRINZA® Suspension is available in 8 mL, and AZOPT® Suspension is available in 10 mL and 15 mL bottles. Unless the patient’s health insurer requires that a particular-sized bottle be used, patients may use any combination of bottles to satisfy the 30-, 60- and 90-day quantities.
Patient instructions: You must call (866) 972‑3008 or visit openingsprogram.com/activate to activate your savings card. Then present the OPENINGS® savings card to your pharmacist along with an eligible prescription for TRAVATAN Z® Solution, SIMBRINZA® Suspension, and/or AZOPT® Suspension each time you fill your prescription. The prescriber ID# must be identified on the prescription. By using the OPENINGS® savings card for an Alcon product, you agree that you will not submit a claim for reimbursement to Medicare Part D, Medicaid, Medigap, VA, DOD, Tricare, or any other government-run or government-sponsored health care program with a pharmacy benefit for that product. In addition, it is important to make sure that you comply with your health insurer’s policies about savings cards. Therefore, if you have health insurance, you agree that you will disclose your use of this offer to your private insurer and that you will use this savings card consistent with your health insurer’s policies, including not seeking reimbursement from your insurer for any amount that Alcon provides towards your copay. You are responsible for any applicable taxes. If you have any questions, please call (866) 972‑3008.
Pharmacist instructions: By submitting a request for reimbursement under the OPENINGS® savings card, you agree to the terms and conditions of the savings card. You may not advertise or otherwise use the OPENINGS® savings card to promote the services of your pharmacy. You agree that you will comply with the policies of the patient’s insurer and will not request payment from Alcon where savings cards are prohibited by the patient’s insurer or by applicable law. You agree that you will inform insurers about use of the savings card as may be required by contract or applicable law. You understand that you may not use the savings card for any patient that you learn is enrolled in a Medicare Part D, Medicaid, Medigap, VA,DOD, Tricare, or any other government-run or government-sponsored health care program with a pharmacy benefit. You may not seek reimbursement from a patient or health insurer for amounts provided by Alcon towards the patient’s copay. Please be aware that Alcon may deny payment if you do not comply with the terms of this offer.
For patients with eligible private insurance: Submit claim to primary Third Party Payer first, then submit the balance due to Therapy First Plus as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code, (e.g., 8). Once the claim is processed, the savings card will be funded and the patient may use savings card to offset amount owed.
For an uninsured patient: Submit claim to Therapy First Plus. A valid Other Coverage Code (e.g.1) is required. Once claim is processed, savings card will be funded and the patient may use savings card to offset amount owed.
If you have questions about Therapy First Plus online processing, call (800) 422‑5604.