| Do I need to activate my card before it can be used? If yes, what is the activation number for this offer? | N/A; there is no activation required. |
| I am unable to enroll in the program, who can complete the enrollment process on my behalf? | Please refer to our ConnectiveRx rep: 1-833-244-2719. |
| Can this offer be used for prescriptions reimbursed under Medicaid, Medicare, TRICARE, or any prescription drug benefit plan? | No. If you are eligible for drug benefits under any such federal or state drug assistance programs, you cannot use this offer. See the card for complete terms. |
| I have Medicare/Medicaid/Tricare, but my prescriptions are not covered. Can I use this offer? | No, if you are eligible for drug benefits under any federal or state drug assistance programs, you cannot use this offer. This includes patients who may fall into the ‘doughnut hole’ or those who are paying for 100% of the prescription out-of-pocket. |
| If I am enrolled in Obamacare or Qualified Health Plans, am I eligible to use the card? | This offer is available to patients covered by Qualified Health Plans issued by Federal or State Exchanges created under the Affordable Care Act. Independent verification of offer availability by the healthcare provider is required for non-Qualified Health Plans issued by the Exchanges. |
| I am a cash paying patient, can I use this offer? | No, this offer is not available to cash paying patients. |
| I have commercial insurance, but Mirena is not covered by my plan, am I considered to be an insured or cash paying patient? | If you have commercial insurance, but this product is not covered by your plan, you are considered cash paying and are not eligible for this offer. |
| I am under 18 years of age. Is my policy holder for my insurance eligible to participate in this program? | Yes, the insurance policy holder is eligible to participate in this program. |
| I received the Mirena Card, does this mean I do not need to have a prescription? | No. The Mirena card is for use ONLY with a valid prescription. |
| Is there a maximum amount the offer will cover per use? | The offer will cover up to $1,214 and it is a one time use. |
| If my provider sends my Mirena prescription to a Specialty Pharmacy, will this program still apply? | Yes, this offer is applicable for Specialty Pharmacy patients that will receive Mirena through a Specialty Pharmacy. |
| If my mail order pharmacy doesn’t accept these cards, can I mail in for a reimbursement? | N/A: this is a buy and bill program. |
| How long after the program expires can I still mail in for a manual reimbursement? | We will process manual reimbursement requests with a service date on or before the program expiration and termination date of 3/31/2025. Reject letters will be sent up until 4/10/2025 for manual reimbursement requests received after the program termination. Bayer Pharmaceuticals also reserves the right to discontinue or modify the program at any time. |
| Is there a patient pay amount? | Patient will pay $20 and Bayer will cover up to $1,214. |
| What do I need to submit for claim reimbursement? | Each claim that will be eligible for reimbursement will need an EOB and the CMS-1500 submitted to ConnectiveRx. |
| If for any reason I need my Mirena card to be replaced, can I reuse this offer? | Please contact our ConnectiveRx rep by calling 1-833-244-2719. |
| How do I opt out of future programs? | Send patient email address to ITServiceDesk@Bayer.com |
