Novo Nordisk Instant Savings Card

Details of Offer Including Restrictions on Eligibility and Other Limitations

Restrictions & Limitations: You are not eligible if prescriptions are paid by any state or other federally funded programs, including, but not limited to Medicare, Medicaid, Medigap, VA, DOD, or TRICARE, or where prohibited by law. Offer not valid for Levemir® FlexPen®, NovoLog® Mix 70/30 FlexPen, or NovoLog® reimbursed in full by any third party payor. Offer limited to 1 card per patient. Offer void where taxed, restricted, or prohibited. Offer only good in the U.S.A. Eligibility is restricted to individuals; no clubs, groups, or organizations. This savings card is not transferable. When you use the Novo Nordisk Instant Savings Card, you are certifying that you understand the program rules, terms and conditions and that you will comply with them.

Offer Details: Pay no more than $25 (up to $100 discount) when you start on a Novo Nordisk product and for each refill for up to 2 years, and no more than $20 (up to $100 discount) for the next prescribed product and each refill for up to 2 years. Offer available for a 30-day supply of Levemir® FlexPen®(insulin detemir [rDNA origin] injection), NovoLog® Mix 70/30 FlexPen® (70% insulin aspart protamine suspension and 30% insulin aspart injection, [rDNA origin]), and NovoLog® (insulin aspart [rDNA origin] injection). Offer valid for a maximum of $100 off your co-pay for each 30-day supply for a maximum of 24 refills per product over 2 years. Novo Nordisk reserves the right to modify or cancel this program at any time.

Needle Offer: Get 1 free box of Novo Nordisk needles when you activate your Instant Savings Card and enroll in the program. Limit 1 box of needles per person. Needles are sold separately and may require a prescription in some states. Needles and FlexPen® must not be shared. Novo Nordisk reserves the right to modify or cancel this program at any time.

How to use the Novo Nordisk Instant Savings Card: You must present the card to the pharmacist along with your prescription to participate in this program. You are not eligible for these savings offers if prescriptions are paid by any state or federally funded programs, including but not limited to Medicare, Medicaid, Medigap, VA, DOD or TriCare, or where prohibited by law. Each time you use this card, you are certifying that you understand the program rules, terms and conditions and that you will comply with them. Please deduct the amount of the discount from any claim for reimbursement submitted to your insurance company or plan. If you have any questions regarding your eligibility or benefits, or if you wish to discontinue your participation, call the Novo Nordisk Instant Savings Card Program at 1-855-292-5966 (8:00 AM-8:00 PM EST, Monday-Friday).