PATIENT SAVINGS PROGRAM

This site is intended for U.S. residents aged 18 and older. Prescribing Information

Get your card

Date of Birth

Please enter in the correct format: MM/DD/YYYY

First Name

Please enter First Name

Last Name

Please enter Last Name

ZIP Code

Please enter ZIP Code

Email Address

Please enter Email Address

Verify Email Address

Please ensure Email Address matches

Marketing Consent: I consent to the collection, use, and disclosure of my health-related personal data to receive communications from AbbVie regarding its products, programs, services, clinical trials, research opportunities and for online targeted advertising, as further described in the “How we may use Personal Data,” “How we disclose Personal Data,” and “Cookies and similar tracking and data collection technologies” sections of our Privacy Notice. My consent is required to process sensitive personal data under certain privacy laws, and I have the right to withdraw my consent by visiting “Your Privacy Choices” on AbbVie’s website.

Privacy Notice: AbbVie may collect your personal data through your online and offline interactions with us, including your contact, demographics, and health-related data. We may also collect your online usage data automatically through cookies and similar technologies. We use this data for several purposes, such as to provide you with and improve our programs, services, and products, customize your experiences, and for research and analytics. We retain your personal data for as long as necessary to fulfill these purposes or to comply with our record retention obligations. We do not sell your personal data but may use and disclose your personal data with marketing and advertising partners to deliver you ads based on your interests inferred from your activity across other unaffiliated sites and services (“online targeted advertising”) and for website analytics. To opt out of the use or disclosure of your personal data for online targeted advertising or for website analytics, go to Your Privacy Choices on our website. For more information on the personal data categories we collect, the purposes for their collection, our disclosures to third parties, your data subject rights, and our data retention criteria, visit our Privacy Notice.

Through my submission of the Savings Program enrollment form, I consent to the collection, use, and disclosure of my personal health data, as described in the Privacy Notice above and in AbbVie’s Privacy Notice in the “How We May Disclose Personal Data” section. My consent is required to process sensitive personal data under certain privacy laws, and I have the right to withdraw my consent by visiting “Your Privacy Choices” on AbbVie’s website.

MOST ELIGIBLE PATIENTS PAY AS LITTLE AS 15 FOR A 90-DAY OR
30-DAY PRESCRIPTION*

Depending on insurance coverage, most eligible patients pay as little as $15 for each of up to twelve 30-day BYSTOLIC^® prescription fills OR each of up to four 90-day BYSTOLIC^® prescription fills. Check with your pharmacist for your copay discount. Maximum savings limits apply; patient out-of-pocket expense will vary. Patients residing in or receiving treatment in certain states may not be eligible. This offer is available to patients with commercial insurance coverage and a valid BYSTOLIC^® prescription. Offer not valid for patients enrolled in Medicare, Medicaid or other federal or state health care programs.

Get your card

Are you a resident of the United States or Puerto Rico?

Yes

Please make a selection

Please select an item in the list.

Do you have commercial prescription drug insurance?

Yes

Please make a selection

By activating your card, you certify that the information provided above is true and correct and that you are not enrolled in a federal- or state-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 program.

I agree to this certification and I accept the Program Terms, Conditions, and Eligibility Criteria available here

Please make a selection

MOST ELIGIBLE PATIENTS PAY AS LITTLE AS 15 FOR A 90-DAY OR
30-DAY PRESCRIPTION*

Program Terms, Conditions, and Eligibility Criteria: 1. This offer is valid only for patients 18 years of age or older and is good for use only with a valid prescription for BYSTOLIC^® (nebivolol) 2.5 mg, 5 mg, 10 mg, and/or 20 mg tablets at the time the prescription is filled by the pharmacist and dispensed to the patient. 2. Depending on your insurance coverage, most eligible patients may pay as little as $15 per 30-day supply for each of up to twelve (12) prescription fills OR per 60-day supply for each of up to six (6) prescription fills OR per 90-day supply for each of up to four (4) prescription fills. Check with your pharmacist for your copay discount. Maximum savings limits apply; patient out-of-pocket expense will vary. 3. This card is not valid for use by patients enrolled in Medicare, Medicaid, or other federal or state programs (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse you for the entire cost of your prescription drugs. Patients may not use this offer if they are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees. This offer is not valid for cash-paying patients. 4. AbbVie reserves the right to rescind, revoke, or amend this offer without notice. 5. Offer good only in the USA, including Puerto Rico, at participating retail pharmacies. 6. Void where prohibited by law, taxed, or restricted. 7. This card is not transferable. The selling, purchasing, trading, or counterfeiting of this card is prohibited by law. 8. This card has no cash value and may not be used in combination with any other discount, coupon, rebate, free trial, or similar offer for the specified prescription. 9. This offer is not health insurance. 10. Subject to all other terms and conditions, the maximum annual benefit that may be available solely for the patient’s benefit under the copay assistance program is $1,360 per calendar year. The actual application and use of the benefit available under the copay assistance program may vary on a monthly, quarterly, and/or annual basis depending on each individual patient’s plan of insurance and other prescription drug costs. 11. By redeeming this card, you acknowledge that you are an eligible patient and that you understand and agree to comply with the terms and conditions of this offer. 12. To learn about AbbVie’s privacy practices and your privacy choices, visit https://abbv.ie/corpprivacy.

For questions about the program, including savings on mail-order prescriptions, please call 1.855.618.0303.

Program managed by ConnectiveRx on behalf of AbbVie.

US-BYS-230011

{"crx-wl-channel":"web","crx-wl-survey-description":"Survey responses.","crx-wl-survey-name":"Survey v1.0.0","groupNumber":"EC97042015","prodURLDomain":"bystolic.copaysavingsprogram.com","client":"abbvie","brand":"bystolic","brandPath":"bystolic","view":"enroll"}

Get your card

MOST ELIGIBLE PATIENTS PAY AS LITTLE AS 15 FOR A 90-DAY OR 30-DAY PRESCRIPTION*

Get your card

MOST ELIGIBLE PATIENTS PAY AS LITTLE AS 15 FOR A 90-DAY OR 30-DAY PRESCRIPTION*

MOST ELIGIBLE PATIENTS PAY AS LITTLE AS 15 FOR A 90-DAY OR
30-DAY PRESCRIPTION*

MOST ELIGIBLE PATIENTS PAY AS LITTLE AS 15 FOR A 90-DAY OR
30-DAY PRESCRIPTION*