Approved Use: Aimovig® is a prescription medicine used for the preventive treatment of migraine in adults.
- Prescribing information
- Patient Product Information
- Instructions for use
- Approved Use
What type of insurance do you use to pay for your Aimovig® prescription at the pharmacy?
Are you eligible for Medicare but receive prescription drug coverage from a former employer, union, or welfare plan?*
Enroll to Get Your Card
Please provide the information below to activate your Copay Card and participate in AimAlly™ support programs.
Required information*
Please provide at least one phone number*
Would you like to enroll in AimAlly™ support?
You have an ally throughout your journey. We're here for you from the start with helpful tools, resources, community content, and more to support you on your path to fewer monthly migraine days.
In addition to the Aimovig® Copay Card, below are even more resources to help you navigate your experience.
Text message refill reminders and your Copay Card sent straight to your phone
Get courtesy reminders to refill your prescription and renew your Copay Card.
By clicking here, you are agreeing to the Terms and Conditions
The Aimovig AimAlly™ 90-Day Start Program
A simple way to get the resources and support you need to navigate your first 3 months on Aimovig and beyond, all in one place.
Required information*
Telephone Consumer Protection Act (TCPA) Consent*
I consent to Amgen calling and texting me at the phone number(s) I have provided with promotional communications relating to Amgen products and services and/or my condition or treatment. Amgen may use automatic dialing machines or artificial or prerecorded messages to contact me and may leave a voicemail or SMS/text message (standard text messaging rates may apply). SMS/text messages from AimAlly™ will be sent to the mobile phone number provided. Reply HELP for help or STOP to cancel. Please click to read the Mobile Terms and Conditions and Privacy Statement. I understand that I am not required to provide this consent as a condition of purchasing any goods or services.
As a next step, please read and provide your responses below to the Patient Authorization and consent(s).
Step 1 of
Authorization for Use and Disclosure of Protected Health Information
Uses and disclosure of Protected Health Information
I authorize Amgen and its data processors (collectively, “Amgen”) to collect, use, and disclose my protected health information for the following purposes:
- To operate, administer, enroll me in, and/or continue my participation in Amgen’s AimAlly™ program or any other Amgen-affiliated patient support services and activities related to my condition or treatment (for example, co-pay card programs, reimbursement assistance programs, drug coverage verification, nurse educator services, adherence program and disease management support);
- To contact, with my permission, my doctor and the rest of my health care team and share with them my health information that may be useful for my care;
- To provide me with informational and promotional materials relating to Amgen products and services, and/or my condition or treatment; and/or
- To improve, develop, and evaluate Amgen’s products, services, materials and programs related to my condition or treatment.
In order for Amgen to provide me with the services and/or programs described above, Amgen needs to collect and use my personal information, including my protected health information. I understand that my protected health information may include any information, in electronic or physical form, in the possession of or derived from a health care provider, health care plan, pharmacy, pharmaceutical company, laboratory and/or their contractor (each, a “Health Care Provider”). This may include select information from or about my medical history and general health, my health care plan benefits, payment limits or restrictions covered by my health care plan policy, and/or my adherence to my treatment.
I authorize my Health Care Providers to disclose my protected health information to Amgen, and between themselves, as necessary, but only for the purposes stated above in this Authorization. I understand that certain of my Health Care Providers (such as pharmacies and specialty pharmacies) may receive remuneration from Amgen in exchange for disclosing my protected health information and/or for using my information to contact me with communications about Amgen products which have been prescribed to me (for example, medication reminder programs and other patient support services).
Expiration, Right to Obtain a Copy, and Right to Cancel
I understand that by signing this form, I authorize my Health Care Providers or others who might hold my health information to disclose it to Amgen. I also understand I am authorizing my personal information, including my protected health information, to be used for the purposes described above. I understand and agree that by signing below, I am authorizing those who rely on this Authorization to disclose my protected health information for the earlier of five (5) years or until my participation in Amgen’s AimAlly™ ends through my cancellation, unless a shorter time period is required by state law.
I understand that I can obtain a copy of this Authorization or cancel this Authorization at any time by calling Amgen at 1-833-246-6844 or by writing to PO Box 2205 Morristown, NJ 07962. If I cancel this Authorization, I will no longer qualify for the services described. I also understand that if a Health Care Provider is disclosing my protected health information to Amgen in reliance on this Authorization on an on-going basis, my cancellation with Amgen will be effective with respect to any such Health Care Providers as soon as they receive notice of my cancellation.
No Effect on Treatment
I understand I do not have to sign this Authorization and that my enrollment in any of the services and/or programs described above is entirely voluntary. I understand that Amgen, as well as Health Care Providers, cannot require me, as a condition of having access to medications, prescription drugs, treatment or other care, to sign this Authorization. Federal Law (including HIPAA) requires a signed authorization in order for Amgen to collect my protected health information from my Health Care Providers. I understand I cannot participate in the listed services and/or programs without signing this Authorization or an equivalent authorization with my Health Care Providers.
Information Received from Health Care Providers
I understand that once my protected health information has been disclosed to Amgen, federal privacy laws may no longer apply and may no longer protect it from further disclosure, and that Amgen may disclose my protect health information to its data processors, contractors, and business partners for its business purposes. Amgen agrees, however, to protect my protected health information by only using and disclosing it as stated in the Authorization or as otherwise allowed or required by law.
By clicking the “I accept” button, I am electronically indicating that I have read and understood the above Authorization for Use and Disclosure of Protected Health Information (above in its full text), that I am legally authorized to consent, and that I am providing my consent as the patient or the patient’s legal representative for Amgen to collect, use, and disclose my protected health information for the purposes described within this Authorization. By clicking “Cancel” below, my activation and enrollment into AimAlly™ will be discontinued.
Step 2 of
Consent to Health Data Processing for AimAlly™
I consent to Amgen processing my Health Data for the following purposes:
- To enroll me and manage my participation in Amgen’s AimAlly™ program, which includes activities related to my condition or treatment (for example, co-pay card programs, payer medication coverage verification, nurse educator support, disease management support), and to manage Amgen’s products, services, and programs related to my condition or treatment.
Amgen uses the following when it administers the AimAlly™ program:
- Health Data – my name (and the name of my caregiver if applicable), gender, date of birth, contact information and information relating to my health condition or treatment.
I understand that my consent to processing is required for me to participate in the AimAlly™ program. I also understand that Amgen will not sell my Health Data to third parties, but Amgen may disclose my Health Data to Amgen’s data processors, contractors, and business partners for Amgen’s business purposes related to the AimAlly™ program. I understand that Amgen may use my Health Data to contact me by mail, email, or telephone for the above purposes. I also understand that if I do not consent to the use of my Health Data for the above purposes, I will not be able to participate in the AimAlly™ program. Finally, I understand that I may withdraw my consent to processing my Health Data for the above purposes at any time using one of the methods listed in the Additional Disclosures section below and that if I withdraw my consent, I will no longer be able to participate in the AimAlly™ program.
Step 3 of
Consent to Health Data Collection & Processing for Marketing Purposes
I consent to Amgen collecting and processing my Health Data for the following purposes:
- To conduct marketing activities, including market research activities, and to communicate with me regarding products and services that may be of interest to me.
Amgen uses the following for marketing purposes:
- Health Data – my name, gender, date of birth, contact information and information relating to my health condition or treatment.
I understand that Amgen is seeking my consent to collect and process my Health Data to market products and services to me and that I do not have to give consent to the collection and processing of my Health Data for marketing purposes in order to participate in the AimAlly™ program. I also understand that Amgen will not sell my Health Data to third parties. If I consent to the collection and processing of my Health Data for marketing purposes, I agree that Amgen may contact me for marketing purposes. Finally, I understand that I may withdraw my consent to the collection and processing of my Health Data for marketing purposes at any time using one of the methods listed in the Additional Disclosures section below.
Step 4 of
Consent to Health Data Disclosure for Marketing Purposes
I consent to Amgen disclosing my Health Data to its data processors, contractors, and business partners for the following purposes:
- To conduct marketing activities, including market research activities, and to communicate with me regarding products and services that may be of interest to me.
Amgen discloses the following for such purposes:
- Health Data – my name, gender, date of birth, contact information and information relating to my health condition or treatment.
I understand that Amgen is seeking my consent to disclose my Health Data to its data processors, contractors, and business partners to market products and services to me and that I do not have to give consent to disclosure of my Health Data for marketing purposes in order to participate in AimAlly™. I also understand that Amgen will not sell my Health Data to third parties. Finally, I understand that I may withdraw my consent to the disclosure of my Health Data for marketing purposes at any time using one of the methods listed in the Additional Disclosures section below.
Additional Disclosures
I understand that participation in the AimAlly™ program and, if I have consented, receipt of marketing communications are optional services at no cost to me. The consent(s) above in no way affects my right to obtain any medications and I do not have to provide consent to be able to receive any medications. To obtain a copy of the consent(s) above or to withdraw my consent to collection, processing, and/or disclosure of my Health Data for any of the above purposes to which I have consented, I can contact Amgen by visiting www.amgen.com/DataSubjectRights or calling 833-AIMOVIG (833-246-6844). For more information about Amgen’s privacy practices, Amgen’s Privacy Statement can be found at http://www.amgen.com/privacy.
Summary of Terms and Conditions
It is important that every patient read and understand the full Aimovig® (erenumab-aooe) Copay Card Terms and Conditions. The following summary is not a substitute for reviewing the Terms and Conditions in their entirety.
As further described below, in general:
- The Aimovig® Copay Card is open to patients with commercial insurance, regardless of financial need. The program is not valid for patients whose Aimovig prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state programs. It is not valid for cash-paying patients or where prohibited by law. (See ELIGIBILITY section below.)
- With the Aimovig® Copay Card, a commercially insured patient who meets eligibility criteria may pay as little as a $5 copay per month for their Aimovig monthly out-of-pocket costs. Monthly out-of-pocket costs include co-payment, co-insurance, and deductible out-of-pocket costs. Amgen will pay the remaining eligible out-of-pocket costs on behalf of the patient up to a Maximum Monthly Benefit, a Maximum Annual Program Benefit and/or the Patient Total Program Benefit. Patients are responsible for all amounts that exceed these limits. (See PROGRAM DETAILS section below.)
- The program provides assistance up to a Maximum Monthly Benefit except that the Maximum Monthly Benefit will not apply to the first 2 uses of the Aimovig® Copay Card for Aimovig in any given calendar year.
- Offer is subject to change or discontinuation without notice.
- The Aimovig® Copay Card provides support up to the Maximum Monthly Benefit, the Maximum Annual Program Benefit and/or Patient Total Program Benefit. If a patient's commercial insurance plan imposes different or additional requirements on patients who receive Aimovig® Copay Card benefits, Amgen has the right to reduce or eliminate those benefits. Whether you are eligible to receive the Maximum Monthly Benefit, Maximum Program Benefit or Patient Total Program Benefit is determined by the type of plan coverage you have. Please ask your AimAlly™ Support Team to help you understand eligibility for the Aimovig® Copay Card, and whether your particular insurance coverage is likely to result in your reaching the Maximum Monthly Benefit, the Maximum Annual Program Benefit, or your Patient Total Program Benefit, by calling 1-833-AIMOVIG (1-833-246-6844). (See PROGRAM BENEFITS section below.)
I. ELIGIBILITY
Eligibility Criteria: Subject to program limitations and terms and conditions, the Aimovig®(erenumab-aooe) Copay Card is open to patients who have an Aimovig prescription and who have commercial or private insurance, including plans available through state and federal healthcare exchanges. This program helps eligible patients cover out-of-pocket costs related to Aimovig, up to program limits. There is no income requirement to participate in this program.
This offer is not valid for patients whose Aimovig prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state programs. It is not valid for cash-paying patients or where prohibited by law. A patient is considered cash-paying where the patient has no insurance coverage for Aimovig or where the patient has commercial or private insurance but Amgen in its sole discretion determines the patient is effectively uninsured because such coverage does not provide a material level of financial assistance for the cost of an Aimovig prescription. This offer is only valid in the United States, Puerto Rico, and the US territories.
II. PROGRAM BENEFITS
The Aimovig® Copay Card helps provide out-of-pocket support to eligible patients for their Aimovig prescription up to program limits. See PROGRAM DETAILS for full description.
The Aimovig® Copay Card offer does not cover out-of-pocket costs for any patient whose selected coverage option under their commercial insurance plan does not apply Aimovig® Copay Card payments to satisfy the patient's co-payment, deductible, or co-insurance for Aimovig. Patients with these plan limitations are not eligible for the Aimovig® Copay Card but may be eligible for other needs-based assistance provided by Amgen. These programs are often referred to as accumulator adjustment programs. If you believe your commercial insurance plan may have such limitations, please contact AimAlly at 1-833-AIMOVIG (833-246-6844).
The Aimovig® Copay Card also may provide a reduced benefit amount, unilaterally determined by Amgen in its sole discretion, to satisfy the out-of-pocket cost-sharing requirement for any patient whose plan or plan agent (including, but not limited to, a Pharmacy Benefit Manager (PBM)) requires enrollment in the Aimovig® Copay Card as a condition of the plan or PBM waiving some or all of an otherwise applicable patient out-of-pocket cost-sharing amount. These programs are often referred to as copay maximizer programs. If you believe your commercial insurance plan may have such limitations, please contact AimAlly at 1-833-AIMOVIG (833-246-6844). Health plans, specialty pharmacies, and Pharmacy Benefit Managers (individually and collectively "Plan Administrators") are prohibited from enrolling patients in the Aimovig® Copay Card. Plan Administrators are prohibited from assisting patients with enrollment in the Aimovig® Copay Card. The patient, or his/her legal representative, must personally enroll in the Aimovig Copay in order to be eligible for program benefits. If at any time a patient begins receiving prescription drug coverage under any state or government program (including but not limited to Medicare, Medicaid, TRICARE, Department of Defense, or Veteran Affairs programs), the patient will no longer be able to use this card and they must contact AimAlly™ at 1-833-AIMOVIG (833-246-6844) (Monday through Friday, from 8AM-9PM ET) to stop their participation in this program.
Patients may not seek reimbursement for the value received from the Aimovig® Copay Card from any third-party payers, including a flexible spending account or healthcare savings account. Participating in this program means that you are ensuring you comply with any required disclosure regarding your participation in the Aimovig® Copay Card of your insurance carrier or Pharmacy Benefit Manager. Restrictions may apply. Offer is subject to change or discontinuation without notice. This is not health insurance.
III. PROGRAM DETAILS
With the Aimovig® Copay Card, a commercially insured patient who meets eligibility criteria may pay as little as a $5 copay per month for their Aimovig monthly out-of-pocket costs.
- For all eligible patients, the Aimovig® Copay Card offers:
- A program benefit that covers the patient's eligible out-of-pocket prescription costs for Aimovig (copay, deductible, or co-insurance) on behalf of the patient, up to a Maximum Monthly Benefit and/or a Maximum Annual Program Benefit.
- Aimovig patients may pay $5 out of pocket at the first fill and at every refill, and Amgen will pay on behalf of the patient the remaining eligible out-of-pocket prescription costs (up to the Patient Total Program Benefit described below; Aimovig patients are responsible for all amounts that exceed this limit).
- The Maximum Monthly Benefit will apply every month except that the first two fills for Aimovig in each calendar year will not have a Maximum Monthly Benefit.
- Maximum Monthly Benefit, Maximum Annual Program Benefit, and/or Patient Total Program Benefit and Benefits May Change, End, or Vary without notice.
- The Maximum Annual Program Benefit must be applied to the Aimovig patient's out-of-pocket costs (copay, deductible, or co-insurance).
- The Patient Total Program Benefit amounts are unilaterally determined by Amgen in its sole discretion and will not exceed the Maximum Monthly Benefit or Maximum Annual Program Benefit. The Patient Total Program Benefit may be less than the Maximum Monthly Benefit or Maximum Annual Program Benefit, depending on the terms of a patient's prescription drug plan, and may vary among individual patients covered by different plans, based on factors determined solely by Amgen, to ensure all programs funds are used for the benefit of the patient. Each patient is responsible for costs above the Patient Total Program Benefit amounts. Please ask your AimAlly representative to help you understand whether your particular insurance coverage is likely to result in your reaching the Maximum Monthly Benefit, Maximum Annual Program Benefit or your Patient Total Program Benefit amount by calling 1-833-AIMOVIG (833-246-6844) and follow the prompts.
- Participating patients are solely responsible for updating Amgen with changes to their prescription health insurance including, but not limited to, initiation of insurance provided by the government, the addition of any coverage terms that do not apply Aimovig® Copay Card benefits to reduce a patient's out-of-pocket costs, such as accumulator adjustment benefit design or a copay maximization program. Participating patients are responsible for providing Amgen with accurate information necessary to determine program eligibility. By accepting payments from Amgen made on behalf of participating patients, participating PBMs and Plans likewise are responsible for providing Amgen with accurate information regarding patient eligibility.
- Patients may use the card every time they fill their Aimovig prescription. Benefits reset each calendar year. Re-enrollment in the program is required at regular intervals. Patients may participate in the program as long as s/he re-enrolls as required by Amgen and s/he continues to meet all of the program's eligibility requirements during participation in the program. Patients can enroll/re-enroll by calling 1-833-AIMOVIG (833-246-6844) or by going to aimovigcopaycard.com.
We appreciate your interest in Aimovig®.
Our AimAlly™ Support Team can provide information on options available.
833-AIMOVIG (833-246-6844)
Monday – Friday, 8 am – 9 pm ET
You can also review our patient FAQs.
Sign up for the AimAlly™ 90-Day Start Program:
a simple way to get the resources and support you need to navigate your first 3 months on Aimovig®, all in one place.
learn more at Aimovig.comWe appreciate your interest in Aimovig®.
Based on the information you provided, it appears that you are not eligible for the Aimovig® Copay Card.
If you have questions about the Aimovig Copay Card, including questions about eligibility, please call the AimAlly™ Support Team at:
833-AIMOVIG (833-246-6844)
Monday – Friday, 8 am – 9 pm ET
You can also review our patient FAQs.
Sign up for the AimAlly™ 90-Day Start Program:
a simple way to get the resources and support you need to navigate your first 3 months on Aimovig®, all in one place.
learn more at Aimovig.comThank you for submitting your information.
We will review your details and contact you with any questions.
Have questions?
Still looking for answers? Don't hesitate to call our AimAlly™ Support Team with questions you may have at 833-AIMOVIG (833-246-6844), Monday – Friday, 8 am – 9 pm ET.
We appreciate your interest in Aimovig®.
Based on the information you provided, it appears that you are not eligible for the Aimovig® Copay Card.
However, Amgen Safety Net Foundation may be able to help.
Please contact them at amgensafetynetfoundation.com.
Have questions?
Still looking for answers? Don't hesitate to call our AimAlly™ Support Team with questions you may have at 833-AIMOVIG (833-246-6844), Monday – Friday, 8 am – 9 pm ET.
Sign up for the AimAlly™ 90-Day Start Program:
a simple way to get the resources and support you need to navigate your first 3 months on Aimovig®, all in one place.
learn more at Aimovig.comIt looks like you may need help with your eligibility.
We're here to help.
Call our AimAlly™ Support Team to learn about available options.
Address suggestions
AimAlly™ Messaging Program Terms
NOTICE: The AimAlly™ mobile program ("Program") for Aimovig® (erenumab-aooe) is not intended to be a source of medical advice or care. Please contact your healthcare provider if you have any questions about your medical condition, diagnosis, treatment or care.
1. By opting into the AimAlly™ mobile program ("Program"), in which you can receive your Aimovig® Copay Card via text, you consent to receive approximately 5 text messages and/or push notifications per month from EngagedMedia. Such messages may include, but are not limited to, claims reversal notifications, refill reminders, fill confirmation, website information, etc. Your mobile service provider is NOT liable for delayed or undelivered messages.
The Program runs on the short code 246-46. Amgen will not charge you to use this Program; however, your Wireless Service Provider may charge for sending and/or receiving messages and for airtime.
2. To stop receiving text messages, text STOP to 246-46. DOING SO WILL ONLY OPT YOU OUT OF THE AIMOVIG® (erenumab-aooe) MOBILE PROGRAM SMS COMMUNICATIONS; you will remain opted in to any other Amgen text message program(s) to which you separately opted in. You may unsubscribe from the Mobile Wallet SMS Message Program at any time by disabling push notifications. You may unsubscribe from the eCard by removing the eCard from your Mobile Wallet.
3. To request more information or to obtain help, text HELP to 246-46. You can also call customer service at 833-246-6844.
4. You represent that you are the account holder for the mobile telephone number(s) that you provide to opt in to the texting program.
5. You agree to promptly notify Amgen if you change your mobile telephone number. You may notify Amgen of a number change at any time. Opt out of the program by texting STOP to 246-46 and re-enrolling in the program with your new mobile telephone number. You also agree to identify Amgen and parties texting on its behalf in full for all claims, expenses, and damages related to or caused (in whole or in part) by your failure to notify Amgen and parties texting on its behalf if you change your telephone number, including but not limited to all claims, expenses, and damages related to or arising under the Telephone Consumer Protection Act.
6. Message and data rates may apply to each text message sent or received in connection with the texting program, as provided in your mobile telephone service rate plan, in addition to any applicable roaming charges. Charges are both billed and payable to your mobile service provider or deducted from your prepaid account. Amgen does not impose a separate fee for sending text messages.
7. You understand that data obtained from you by Amgen or its partners, in connection with your registration for, and use of, the Program may include, for example, your phone number, related carrier information, device information, and elements of pharmacy claim information. This data may be used to administer this program and to provide program benefits such as savings offers, information about your prescription, refill reminders, as well as program updates and alerts sent directly to your device.
8. You understand that data obtained from you in connection with your registration for, and use of, the Program may include, for example, your phone number, related carrier information, device information, and elements of pharmacy claim information. This data may be used to administer this program and to provide program benefits such as access offers, information about your prescription, refill reminders, as well as program updates and alerts sent directly to your device. Please read Amgen's full Privacy Statement, which is incorporated by reference into these Terms.
9. In addition to the data use practices described in the Privacy Statement, we may send you Offer-related push notifications when your device is in the physical proximity of your pharmacy or healthcare provider. This is done through geofencing technology, which is built in to your device. Your device's location will not be known or tracked by Amgen or its service providers. Nonetheless, you may opt out of geofencing and receiving these notifications at any time by (1) disabling location services for your Mobile Wallet app in your device's settings, (2) disabling notifications (i.e., automatic updates) within the Mobile Wallet app, or (3) removing the eCard from your Mobile Wallet by selecting "Remove Pass" within the Mobile Wallet app.
10. Amgen will not be liable for any delays in the receipt of any SMS messages, as delivery is subject to effective transmission from your network operator.
11. The service is available only on these US participating mobile carriers: Verizon Wireless, Sprint, Nextel, Boost Mobile, T-Mobile, AT&T, Alltel, ACS Wireless, Bluegrass Cellular, Carolina West Wireless, Cellcom, Cellular One of East Central Illinois (ECIT), Cincinnati Bell, Cricket Wireless, C Spire Wireless, Duet IP (AKA Max/Benton/Albany), Element Mobile, Epic Touch, GCI Communication, Golden State Cellular, Hawkeye (Chat Mobility), Hawkeye (NW Missouri Cellular), Illinois Valley Cellular (IVC), Inland Cellular, iWireless, Keystone Wireless (lmmix/PC Management), MetroPCS, Mobi PCS, Mosaic Telecom, MTPCS/Cellular One (Cellone Nation), Nex-Tech Wireless, nTelos, Panhandle Telecommunications, Pioneer, Plateau, Revol Wireless, Rina-Custer, Rina-All West, Rina-Cambridge Telecom Coop, Rina-Eagle Valley Comm, Rina-Farmers Mutual Telephone Co, Rina-Nucla Nutria Telephone Co, Rina-Silver Star, Rina-South Central Comm, Rina-Syringa, Rina-UBET, Rina-Manti, Simmetry Wireless, South Canaan (Cellular One of NEPA), Thumb Cellular, Union Wireless, United Wireless, U.S. Cellular, Viaero Wireless, Virgin Mobile, West Central Wireless (includes Five Star Wireless).
12. You acknowledge that the reliability of the timeliness of Program refill notifications depends upon, the information you provide, which includes, but is not limited to, phone number and device information, elements of claims information related to your prescription, and the functionality of your device. Be sure to accurately provide information so you receive notifications on time. This Program is not intended to replace the Patient Instructions for Use and any other information provided to you by your healthcare provider, which are intended to be the sources of information on which you should rely to understand how to use Aimovig®.
13. DISCLAIMER: The Program is provided "as is." Amgen, EngagedMedia and its partners make no warranties, express or implied, regarding the functionality or accessibility of the Program or the timeliness, contents or reliability of any refill reminders, fill confirmations, claims reversal notifications or any other SMS messages or push notifications, and expressly disclaim any implied warranty of merchantability or fitness for a particular purpose. To the maximum extent permitted by law, Amgen and its partners hereby disclaim and will not be liable for any direct, indirect, consequential, special, incidental, punitive or any other damages or injury arising from or relating in any way to your use of the Program, including but not limited to any costs or expenses or loss of insurance coverage for Aimovig® resulting from non-receipt or untimely receipt of any notifications or inaccessibility of the Program.
14. Amgen may suspend or terminate your receipt of text messages if it believes you are in breach of these Mobile Program Terms and Conditions. Your receipt of text messages is also subject to termination in the event that your mobile telephone service terminates or lapses. Amgen reserves the right to modify or discontinue, temporarily or permanently, all or any part of the text messaging services you receive, with or without notice.
15. Amgen may revise, modify, or amend these Mobile Program Terms and Conditions at any time. Any such revision, modification, or amendment shall take effect when it is posted to Amgen's website. You agree to review these Mobile Program Terms and Conditions periodically to ensure that you are aware of any changes. Your continued consent to receive text messages and include the eCard on your Mobile Wallet will indicate your acceptance of those changes.
Program Details and Terms and Conditions
Summary of Terms and Conditions
It is important that every patient read and understand the full Aimovig® (erenumab-aooe) Copay Card Terms and Conditions. The following summary is not a substitute for reviewing the Terms and Conditions in their entirety.
As further described below, in general:
- The Aimovig® Copay Card is open to patients with commercial insurance, regardless of financial need. The program is not valid for patients whose Aimovig prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state programs. It is not valid for cash-paying patients or where prohibited by law. (See ELIGIBILITY section below.)
- With the Aimovig® Copay Card, a commercially insured patient who meets eligibility criteria may pay as little as a $5 copay per month for their Aimovig monthly out-of-pocket costs. Monthly out-of-pocket costs include co-payment, co-insurance, and deductible out-of-pocket costs. Amgen will pay the remaining eligible out-of-pocket costs on behalf of the patient up to a Maximum Monthly Benefit, a Maximum Annual Program Benefit and/or the Patient Total Program Benefit. Patients are responsible for all amounts that exceed these limits. (See PROGRAM DETAILS section below.)
- The program provides assistance up to a Maximum Monthly Benefit except that the Maximum Monthly Benefit will not apply to the first 2 uses of the Aimovig® Copay Card for Aimovig in any given calendar year.
- Offer is subject to change or discontinuation without notice.
- The Aimovig® Copay Card provides support up to the Maximum Monthly Benefit, the Maximum Annual Program Benefit and/or Patient Total Program Benefit. If a patient's commercial insurance plan imposes different or additional requirements on patients who receive Aimovig® Copay Card benefits, Amgen has the right to reduce or eliminate those benefits. Whether you are eligible to receive the Maximum Monthly Benefit, Maximum Program Benefit or Patient Total Program Benefit is determined by the type of plan coverage you have. Please ask your AimAlly™ Support Team to help you understand eligibility for the Aimovig® Copay Card, and whether your particular insurance coverage is likely to result in your reaching the Maximum Monthly Benefit, the Maximum Annual Program Benefit, or your Patient Total Program Benefit, by calling 1-833-AIMOVIG (1-833-246-6844). (See PROGRAM BENEFITS section below.)
I. ELIGIBILITY
Eligibility Criteria: Subject to program limitations and terms and conditions, the Aimovig®(erenumab-aooe) Copay Card is open to patients who have an Aimovig prescription and who have commercial or private insurance, including plans available through state and federal healthcare exchanges. This program helps eligible patients cover out-of-pocket costs related to Aimovig, up to program limits. There is no income requirement to participate in this program.
This offer is not valid for patients whose Aimovig prescription is paid for in whole or in part by Medicare, Medicaid, or any other federal or state programs. It is not valid for cash-paying patients or where prohibited by law. A patient is considered cash-paying where the patient has no insurance coverage for Aimovig or where the patient has commercial or private insurance but Amgen in its sole discretion determines the patient is effectively uninsured because such coverage does not provide a material level of financial assistance for the cost of an Aimovig prescription. This offer is only valid in the United States, Puerto Rico, and the US territories.
II. PROGRAM BENEFITS
The Aimovig® Copay Card helps provide out-of-pocket support to eligible patients for their Aimovig prescription up to program limits. See PROGRAM DETAILS for full description.
The Aimovig® Copay Card offer does not cover out-of-pocket costs for any patient whose selected coverage option under their commercial insurance plan does not apply Aimovig® Copay Card payments to satisfy the patient's co-payment, deductible, or co-insurance for Aimovig. Patients with these plan limitations are not eligible for the Aimovig® Copay Card but may be eligible for other needs-based assistance provided by Amgen. These programs are often referred to as accumulator adjustment programs. If you believe your commercial insurance plan may have such limitations, please contact AimAlly at 1-833-AIMOVIG (833-246-6844).
The Aimovig® Copay Card also may provide a reduced benefit amount, unilaterally determined by Amgen in its sole discretion, to satisfy the out-of-pocket cost-sharing requirement for any patient whose plan or plan agent (including, but not limited to, a Pharmacy Benefit Manager (PBM)) requires enrollment in the Aimovig® Copay Card as a condition of the plan or PBM waiving some or all of an otherwise applicable patient out-of-pocket cost-sharing amount. These programs are often referred to as copay maximizer programs. If you believe your commercial insurance plan may have such limitations, please contact AimAlly at 1-833-AIMOVIG (833-246-6844). Health plans, specialty pharmacies, and Pharmacy Benefit Managers (individually and collectively "Plan Administrators") are prohibited from enrolling patients in the Aimovig® Copay Card. Plan Administrators are prohibited from assisting patients with enrollment in the Aimovig® Copay Card. The patient, or his/her legal representative, must personally enroll in the Aimovig Copay in order to be eligible for program benefits. If at any time a patient begins receiving prescription drug coverage under any state or government program (including but not limited to Medicare, Medicaid, TRICARE, Department of Defense, or Veteran Affairs programs), the patient will no longer be able to use this card and they must contact AimAlly™ at 1-833-AIMOVIG (833-246-6844) (Monday through Friday, from 8AM-9PM ET) to stop their participation in this program.
Patients may not seek reimbursement for the value received from the Aimovig® Copay Card from any third-party payers, including a flexible spending account or healthcare savings account. Participating in this program means that you are ensuring you comply with any required disclosure regarding your participation in the Aimovig® Copay Card of your insurance carrier or Pharmacy Benefit Manager. Restrictions may apply. Offer is subject to change or discontinuation without notice. This is not health insurance.
III. PROGRAM DETAILS
With the Aimovig® Copay Card, a commercially insured patient who meets eligibility criteria may pay as little as a $5 copay per month for their Aimovig monthly out-of-pocket costs.
- For all eligible patients, the Aimovig® Copay Card offers:
- A program benefit that covers the patient's eligible out-of-pocket prescription costs for Aimovig (copay, deductible, or co-insurance) on behalf of the patient, up to a Maximum Monthly Benefit and/or a Maximum Annual Program Benefit.
- Aimovig patients may pay $5 out of pocket at the first fill and at every refill, and Amgen will pay on behalf of the patient the remaining eligible out-of-pocket prescription costs (up to the Patient Total Program Benefit described below; Aimovig patients are responsible for all amounts that exceed this limit).
- The Maximum Monthly Benefit will apply every month except that the first two fills for Aimovig in each calendar year will not have a Maximum Monthly Benefit.
- Maximum Monthly Benefit, Maximum Annual Program Benefit, and/or Patient Total Program Benefit and Benefits May Change, End, or Vary without notice.
- The Maximum Annual Program Benefit must be applied to the Aimovig patient's out-of-pocket costs (copay, deductible, or co-insurance).
- The Patient Total Program Benefit amounts are unilaterally determined by Amgen in its sole discretion and will not exceed the Maximum Monthly Benefit or Maximum Annual Program Benefit. The Patient Total Program Benefit may be less than the Maximum Monthly Benefit or Maximum Annual Program Benefit, depending on the terms of a patient's prescription drug plan, and may vary among individual patients covered by different plans, based on factors determined solely by Amgen, to ensure all programs funds are used for the benefit of the patient. Each patient is responsible for costs above the Patient Total Program Benefit amounts. Please ask your AimAlly representative to help you understand whether your particular insurance coverage is likely to result in your reaching the Maximum Monthly Benefit, Maximum Annual Program Benefit or your Patient Total Program Benefit amount by calling 1-833-AIMOVIG (833-246-6844) and follow the prompts.
- Participating patients are solely responsible for updating Amgen with changes to their prescription health insurance including, but not limited to, initiation of insurance provided by the government, the addition of any coverage terms that do not apply Aimovig® Copay Card benefits to reduce a patient's out-of-pocket costs, such as accumulator adjustment benefit design or a copay maximization program. Participating patients are responsible for providing Amgen with accurate information necessary to determine program eligibility. By accepting payments from Amgen made on behalf of participating patients, participating PBMs and Plans likewise are responsible for providing Amgen with accurate information regarding patient eligibility.
- Patients may use the card every time they fill their Aimovig prescription. Benefits reset each calendar year. Re-enrollment in the program is required at regular intervals. Patients may participate in the program as long as s/he re-enrolls as required by Amgen and s/he continues to meet all of the program's eligibility requirements during participation in the program. Patients can enroll/re-enroll by calling 1-833-AIMOVIG (833-246-6844) or by going to aimovigcopaycard.com.