SKYRIZI MAY COST YOU AS LITTLE AS $5* PER TREATMENT

Skyrizi Complete Savings Card Terms & Conditions

Terms and Conditions apply. This benefit covers SKYRIZI® (risankizumab-rzaa) alone or for SKYRIZI with product associated infusion (maximum savings limit of $1,000 per year applies) and eligible liver enzyme and bilirubin lab monitoring costs (maximum savings limit of $1,000 per year applies) where the full cost is not covered by a patient’s insurance. Patient or healthcare provider is required to submit an Explanation of Benefits (EOB) following each infusion and/or laboratory test to the Co-Pay Program. Eligibility: Available to patients with commercial insurance coverage for SKYRIZI who meet eligibility criteria. Co-pay assistance program is not available to patients receiving reimbursement under any federal, state, or government-funded insurance programs (for example, Medicare [including Part D], Medicare Advantage, Medigap, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs) or where prohibited by law or by the patient’s health insurance provider. If at any time a patient begins receiving drug coverage under any such federal, state, or government-funded healthcare program, patient will no longer be able to use the Skyrizi Complete Savings Card and patient must call Skyrizi Complete at 1.866.SKYRIZI to stop participation. By enrolling in the co-pay assistance program, you agree that this program is intended solely for the benefit of you, the patient.  Some health plans have established programs referred to as “accumulator adjustment” or “co-pay maximizer” programs.  An accumulator adjustment program is one in which payments made by you that are subsidized by manufacturer assistance do not count toward your deductibles and other out-of-pocket cost sharing limitations.  Co-pay maximizers are programs in which the amount of your out-of-pocket costs is increased to reflect the availability of support offered by a manufacturer assistance program.  Except where prohibited by applicable state law, if your insurance company or health plan implements either an accumulator adjustment or co-pay maximizer program, you will not be eligible for, and agree not to use, co-pay assistance because these programs are inconsistent with our agreed intent that this program is solely for your benefit.  You also agree that you are personally responsible for paying any amount of co-pay required after the savings card is applied. Any out-of-pocket costs remaining after the application of the savings card may not be paid by your health plan, pharmacy benefit programs, or any other program.   If you learn your insurance company or health plan has implemented either an accumulator adjustment program or a co-pay maximizer program, you agree to inform AbbVie of this fact by calling 1.866.SKYRIZI to discuss alternative options that may be available to support you. Since you may be unaware whether you are subject to a co-pay maximizer program when you enroll in the co-pay assistance program, AbbVie will monitor program utilization data and reserves the right to discontinue co-pay assistance at any time if AbbVie determines that you are subject to a co-pay maximizer program. For such patients, except where prohibited by applicable state law, AbbVie may discontinue the availability of co-pay support at an amount not to exceed $4,000.00. This amount is subject to change without notice. If your health plan removes SKYRIZI from a co-pay maximizer program, you will return to eligibility for co-pay assistance up to the maximum annual benefit listed below. Subject to all other terms and conditions, the maximum annual benefit that may be available solely for the patient’s benefit under the co-pay assistance program is $14,000 per calendar year. The actual application and use of the benefit available under the co-pay 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. This co-pay assistance program is subject to change, reduction in monetary amount, or discontinuation without any notice.  AbbVie in its sole discretion may unilaterally reduce or discontinue the maximum annual benefit for any reason.  Except where prohibited by applicable law, this includes potential reduction or discontinuation to ensure that co-pay assistance is utilized solely for the patient’s benefit. Patients may not seek reimbursement for value received from the Skyrizi Complete Program from any third-party payers. Offer subject to change or discontinuance without notice. Restrictions, including monthly maximums, may apply. This assistance offer is not health insurance. By utilizing this co-pay assistance program, you hereby accept and agree to abide by these terms and conditions.  Any individual or entity who enrolls or assists in the enrollment of a patient in the co-pay assistance program represents that the patient meets the eligibility criteria and other requirements described herein.  Further, you agree that you currently meet the eligibility criteria and other requirements described herein every time you use the co-pay assistance program. To learn about AbbVie’s privacy practices and your privacy choices, visit https://privacy.abbvie

This Copay Assistance Card is issued by Florida Capital Bank pursuant to a license from Mastercard International. Serviced by Transcard LLC. The funds available through use of this Copay Assistance Card are not your property but are supplied exclusively by AbbVie Inc. No balance on this Copay Assistance Card is redeemable for cash or credit in the form of a refund, credit, change, or otherwise. This Copay Assistance Card may only be used for prescription medication at participating pharmacies and other approved locations, and for the specific purpose(s) expressly authorized by AbbVie Inc. Terms of Use, as amended from time to time. For a copy of the Terms of Use, please visit SKYRIZICDSavingsCard.com. For customer service questions or to report your Card lost or stolen, call 888-857-0636.

Banking services provided by FLCBank, Member FDIC. The Skyrizi Complete Savings Mastercard is issued by FLCBank pursuant to a license Mastercard Inc. and may be used everywhere Mastercard cards are accepted.