FAST FACTS: TYPE 1
DIABETES

With the Afrezza® Savings Card, an eligible, commercially-insured patient age 18 years and older can receive this Copay Offer, see details below.

If coverage for Afrezza (insulin human) Inhalation Powder is approved by the patient’s health plan, a patient can qualify for the Copay Offer and pay as little as $35 per fill (saving as much as $2000 per month), up to a maximum of 12 fills annually. Maximum limits apply. See full Terms and Conditions below.

By participating in the Afrezza Savings Card program, you acknowledge that you are an eligible patient, age 18 years or older, and that you understand and agree to comply with the terms and conditions of this offer, as described in further detail below.

Terms and Conditions for Copay Offer: Pay as little as $35 for Afrezza® per month, up to a maximum savings of $2000. Patient must be prescribed Afrezza (insulin human) Inhalation Powder. Patient will pay as little as $35 per month (saving as much as $2000 per month), up to a maximum of 12 fills annually. The Copay Offer applies to patient out-of-pocket costs, including deductible, co-insurance, and copayments for Afrezza. Patient is responsible for the first $35 and any costs above the maximum benefit limit. Available if patient is commercially insured and 18 years or older. This offer is not valid if patient is receiving prescription reimbursement under any federal-, state-, or government-funded healthcare program, such as Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), the Department of Defense (DoD), or TRICARE or where prohibited by law. If at any time patient begins receiving coverage under any such federal-, state-, or government-funded healthcare program, patient will no longer be able to use this offer and patient must call 1-844-3AFREZZA / 1-844-323-7399 to discontinue participation. Patient may not seek reimbursement for value received from this offer from any third-party payers, including flexible spending accounts or healthcare savings accounts. Other restrictions may apply. This offer is subject to change or discontinuation without notice. This is not health insurance. If you become aware that your health plan or pharmacy benefit manager does not allow the use of manufacturer copay support as part of your health plan design, you agree to comply with your obligations, if any, to disclose your use of the card to your insurer. Offer benefits will reset annually; on-going participation may require periodic re-enrollment. Valid in the United States, Puerto Rico, and the US territories.

Maximum Quantities Allowed Under Copay Offer:
NDC 47918-0874-90, 47918-0878-90; NDC 47918-0891-90:
Max 810 cartridges/ 90 Day Supply
NDCs 47918-0880-18; NDC 47918-0902-18; NDC 47918-0898-18:
Max 1,620 cartridges/ 90 Day Supply

For additional questions regarding program benefits, terms, conditions or participation requirements, please contact 1-844-3AFREZZA / 1-844-323-7399.

With the Afrezza® Savings Card, an eligible, commercially-insured patient age 18 years and older can receive this Copay Offer, see details below.

If coverage for Afrezza (insulin human) Inhalation Powder is approved by the patient’s health plan, a patient can qualify for the Copay Offer and pay as little as $35 per fill (saving as much as $2000 per month), up to a maximum of 12 fills annually. Maximum limits apply. See full Terms and Conditions below.

By participating in the Afrezza Savings Card program, you acknowledge that you are an eligible patient, age 18 years or older, and that you understand and agree to comply with the terms and conditions of this offer, as described in further detail below.

Terms and Conditions for Copay Offer: Pay as little as $35 for Afrezza® per month, up to a maximum savings of $2000. Patient must be prescribed Afrezza (insulin human) Inhalation Powder. Patient will pay as little as $35 per month (saving as much as $2000 per month), up to a maximum of 12 fills annually. The Copay Offer applies to patient out-of-pocket costs, including deductible, co-insurance, and copayments for Afrezza. Patient is responsible for the first $35 and any costs above the maximum benefit limit. Available if patient is commercially insured and 18 years or older. This offer is not valid if patient is receiving prescription reimbursement under any federal-, state-, or government-funded healthcare program, such as Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), the Department of Defense (DoD), or TRICARE or where prohibited by law. If at any time patient begins receiving coverage under any such federal-, state-, or government-funded healthcare program, patient will no longer be able to use this offer and patient must call 1-844-3AFREZZA / 1-844-323-7399 to discontinue participation. Patient may not seek reimbursement for value received from this offer from any third-party payers, including flexible spending accounts or healthcare savings accounts. Other restrictions may apply. This offer is subject to change or discontinuation without notice. This is not health insurance. If you become aware that your health plan or pharmacy benefit manager does not allow the use of manufacturer copay support as part of your health plan design, you agree to comply with your obligations, if any, to disclose your use of the card to your insurer. Offer benefits will reset annually; on-going participation may require periodic re-enrollment. Valid in the United States, Puerto Rico, and the US territories.

Maximum Quantities Allowed Under Copay Offer:
NDC 47918-0874-90, 47918-0878-90; NDC 47918-0891-90:
Max 810 cartridges/ 90 Day Supply
NDCs 47918-0880-18; NDC 47918-0902-18; NDC 47918-0898-18:
Max 1,620 cartridges/ 90 Day Supply

For additional questions regarding program benefits, terms, conditions or participation requirements, please contact 1-844-3AFREZZA / 1-844-323-7399.