Offer Statement
With the BOTOX® Savings Card you can get up to $400 off one treatment received January-March 2016 and up to $200 off per treatment for up to 4 treatments received April-December 2016 for people with Chronic Migraine. All treatments must be received within a 12-month period.
Card Usage Language
Your BOTOX® Savings Card may only be used at hospitals, physician offices, and pharmacies, and will not be accepted at any other location that normally accepts Visa® Debit cards. The BOTOX® Savings Card cannot be used at merchants outside the United States (including Internet and mail/telephone merchants).
The BOTOX® Savings Card is issued by Metropolitan Commercial Bank, member FDIC, pursuant to license by Visa U.S.A. Inc. "Metropolitan Commercial Bank" and "Metropolitan" are registered trademarks of Metropolitan Commercial Bank ©2014. See the Cardholder Agreement for Terms and Conditions. By accepting, signing, or using this savings card, you agree to the Terms and Conditions of the Cardholder Agreement. This savings card will remain the property of the issuing institution and the privilege of its use may be withdrawn at any time.
TERMS AND CONDITIONS
By participating, you understand and agree to comply with the Program rules as set forth below.
Offer is not valid for any other products or other out-of-pocket costs, even if those costs are associated with the administration of BOTOX® treatment. The BOTOX® Savings Card will be funded upon approval of claim form and EOB or SPP receipt. (If the BOTOX® prescription was filled by a Specialty Pharmacy Provider, both EOB and SPP receipt must be sent.) BOTOX® Savings Card may not be combined with any other offer or discount. This BOTOX® Savings Card is not health insurance. Patient must submit a claim form and EOB or SPP receipt within 90 days from the date of service.
Offer not valid for patients participating in Medicare, Medicaid, or any similar federal or state healthcare program, including any state medical or pharmaceutical assistance programs. If patients are eligible for drug benefits under any such program, they cannot use this BOTOX® Savings Card.
Offer void where prohibited by law, taxed, or restricted. Offer good only in the United States. Allergan, Inc., reserves the right to rescind, revoke, and amend this offer without notice.
Metropolitan Commercial Bank and Metropolitan are registered trademarks of Metropolitan Commercial Bank.
Visa is a registered trademark of Visa International Service Association.