PHEXXI® SAVINGS PROGRAM
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WELCOME TO THE PHEXXI SAVINGS PROGRAM

ELIGIBLE PATIENTS MAY RECEIVE PHEXXI FOR FREE

See program Terms, Conditions, and Eligibility Criteria.

Please see full Prescribing Information for Phexxi, including Patient Information.

Depending on your insurance coverage, eligible patients may pay $0 for their Phexxi prescriptions. Check with your pharmacist for your co-pay discount. Maximum savings limits apply; patient out-of-pocket expense will vary. Offer not valid for patients enrolled in Medicare, Medicaid, other federal or state healthcare programs, or where prohibited by law. See program Terms, Conditions, and Eligibility Criteria.

YOU MAY BE ELIGIBLE FOR SAVINGS. SIGN-UP IS EASY. START NOW!

PLEASE TELL US ABOUT YOURSELF

*Required Field.

Please enter First Name.
Please enter Last Name.
Please enter a valid email.
 

PLEASE ANSWER THE FOLLOWING QUESTIONS

Do you live in the United States or Puerto Rico?
Please select Yes or No.
Do you have commercial prescription drug insurance? (If you have Medicaid, Medicare, or other government-sponsored prescription insurance, such as VA/DOD, select “No”)
Please select Yes or No.

By activating your Phexxi Savings Offer, you certify that you are not enrolled in a federal government- or state government-funded prescription drug benefit program, such as Medicare, Medicaid, or any private indemnity or HMO insurance plan that reimburses you for the entire cost of your prescription drugs. You also certify that you are not Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. You further certify that should you begin receiving prescription benefits from one of these types of programs at any time, you will no longer participate in this savings programs.

Please agree to this statement to participate in this program.

IF YOU HAVE ANY QUESTIONS ABOUT THE PHEXXI SAVINGS PROGRAM, PLEASE CALL 1-855-358-6583.

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