Vevye Coupon

For patients whose prescriptions are covered by commercial insurance, use of this card may reduce your copayment so that you may pay as little as $0.
For patients whose prescriptions are not covered by commercial insurance, use of this card may reduce your cost for prescriptions to as little as $59.
This card is not valid for prescriptions paid for in part or full by Medicare, Medicaid, Tricare, DOD, VA, or any state or federally funded program.
This program is subject to overall maximum support amounts.
This offer shall be applied only toward the cost of an eligible prescription product and not toward ancillary services or treatment costs.
This offer is only good in the United States of America (including the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands).
You must present this coupon along with your prescription to participate in this program.
This offer is not health insurance.
The selling, trading, or counterfeiting of this coupon is prohibited by law. Void if reproduced.
This offer is not transferable.
When you use this offer, you are certifying that you understand and agree to comply with the program rules, regulations, eligibility requirements, and Terms and Conditions.
Harrow reserves the right to rescind, revoke, or amend this offer at any time.

Pharmacist Instructions For Commercially Insured Patients:

Submit the claim to the primary commercial insurance company.
Submit the balance due as a Secondary Submission COB with the patient responsibility amount and a valid Other Coverage Code (OCC).
For eligible commercial patients when the product is covered, submit BIN and OCC 08. For eligible commercial patients when the product is not covered, submit BIN and OCC 03.

Program Terms and Conditions

When you process this card, you certify that you have read, understood, and are in compliance with the terms and conditions pertaining to this program. You are further certifying that you have not submitted and will not submit a claim for reimbursement under Medicare or similar federal or state programs including any state medical pharmaceutical assistance program for this prescription.
Harrow reserves the right to rescind, revoke, or amend this offer at any time.