Terms and conditions of use

Eligibility and Restrictions:

In order to redeem this offer, the patient must have a valid prescription for the brand being filled. A valid Prescriber ID# is required on the prescription. This offer is available for all 5 different dose strengths of Wegovy^®. The patient is not eligible if he/she is enrolled in any federal or state health care program with prescription drug coverage, such as Medicaid, Medicare, VA, DOD, TRICARE, or any similar federal or state health care program (each a government program), or where prohibited by law. Patients enrolled in a federal or state health care program may not use this program, even if they elect to be processed as an uninsured or self-paying patient. Patients are also ineligible for this offer if they are Medicare-eligible and enrolled in an employer-sponsored group waiver health plan (EGWP) or government-subsidized prescription drug benefit program for retirees. Note: The Federal Employees Health Benefits (FEHB) Program, Affordable Care (Health Exchange) Plans, and insurance provided through state employee plans are NOT federal or state government health care programs for purposes of this savings offer (the “Savings Offer”). Self-paying patients are defined as uninsured patients, insured patients who do not have coverage for Wegovy^® under their plan, or insured patients with product coverage opting to process the prescription outside of their insurance plan. This offer may not be redeemed for cash. This offer is not valid when the entire cost of your prescription drug is eligible to be reimbursed by a commercial insurance plan or other commercial health or pharmacy benefit programs. Medication filled prior to enrollment in this program will not be eligible for copay assistance and cannot be reimbursed. By using this offer, you are certifying that you meet the eligibility criteria, will comply with the terms and conditions described herein, and will not seek reimbursement for any benefit received through this offer. Novo Nordisk’s Eligibility and Restrictions, and Offer Details, may change from time to time, and for the most recent version, please visit this webpage. Reconfirmation of patient information may be requested periodically to ensure accuracy of data and compliance with terms. Patients with questions about the savings offer may call 1‑888‑793‑1218.

This offer is valid only in the United States and its territories, unless prohibited by law, and may be redeemed at participating retail pharmacies. Availability of the savings offer in Massachusetts will be dependent upon state law in effect at the time the patient presents the savings offer when paying for the covered medications. This offer is not transferable and is limited to one offer per person. Not valid if reproduced.

Cash Discount Cards and other noninsurance plans are not valid as primary insurance under this offer. If the patient is eligible for drug benefits under any such program, the patient cannot use this offer. This savings offer is provided solely for the benefit of the patient. This savings offer may be combined with a manufacturer-sponsored automatic eVoucher offer (at participating pharmacies) but cannot be combined with any other coupon, certificate, voucher, or similar offer. This includes, without limitation, any program offered through a third-party payer or pharmacy benefits manager, or an agent of either, that adjusts cost-sharing obligations. No other purchase is necessary.

The patient is responsible for complying with any insurance carrier copayment disclosure requirements, including disclosing any savings received from this program. Novo Nordisk intends that all savings from this offer accrue to the patient and are intended to be credited toward patient out-of-pocket obligations and maximums, including applicable copayments, coinsurance, and deductibles. Some insurance plans have established programs that require you to enroll in a manufacturer copay assistance program, including:

• Programs in which payments made by you that are subsidized by manufacturer savings offer programs do not count toward your deductibles or other patient out-of-pocket cost-sharing amounts (eg, accumulator adjustment programs); and/or
• Programs that adjust patient out-of-pocket cost-sharing amounts based on the availability of a manufacturer savings offer (eg, maximizer programs)

If your insurer has implemented these types of programs, you will not be eligible for and agree not to use this savings program, and Novo Nordisk reserves the right to reduce or discontinue financial assistance under this savings program, including, but not limited to, reducing your per-claim maximum savings benefit and/or your annual maximum savings benefit. If you learn that your insurance company or health plan has implemented either an accumulator adjustment program or a copay maximizer program, you agree to inform Novo Nordisk. Since you may be unaware whether you are subject to an accumulator adjustment or copay maximizer program when you enroll in the Novo Nordisk Saving Program, Novo Nordisk will monitor program utilization data and reserves the right to reduce, discontinue, or otherwise modify this savings offer at any time, with or without notice.

It is illegal to (or offer to) sell, purchase, or trade this offer. 

This program is not health insurance. This program is managed by ConnectiveRx on behalf of Novo Nordisk. The parties reserve the right to rescind, revoke, or amend this offer without notice at any time.

Offer Details

Wegovy^® (semaglutide) injection 2.4 mg:

For patients with commercial insurance who have coverage for Wegovy^®: As of March 17, 2025 (“Effective Date”), pay as little as (“PALA”) $0 for up to thirteen (13) 28-day fills (1 box) of Wegovy^®, subject to a maximum savings of $225 per 28-day supply (1 box) (“Savings Benefit”), $450 per 56-day supply (2 boxes), or $675 per 84-day supply (3 boxes).

For patients with commercial insurance that does not cover Wegovy^®, or those that are self-paying/opting to process outside of their commercial insurance plan: Pay $499 per 28-day supply (1 box), $998 per 56-day supply (2 boxes), or $1,497 per 84-day supply (3 boxes) of Wegovy^®. Please Note: Government Beneficiaries, including but not limited to patients enrolled in Medicare or Medicaid, are not eligible for this offer even if they elect to go outside of insurance and self-pay. This offer can be used by commercially insured patients with product coverage that opt to self-pay and not use their insurance coverage, but by redeeming this offer, you (and anyone else acting on your behalf) agree not to seek reimbursement from any insurance plan for out-of-pocket costs for prescriptions purchased with this offer. You also understand that using this offer means the prescription will be processed outside of any insurance and will not count towards any deductibles and cannot be applied to any insurance maximum out-of-pocket limits.

Commercially insured patients may be eligible for additional savings if they are prescribed a dose de-escalation within 21 days after the date of fill for the original dose by their health care provider necessitating them to fill an injection with a lower dosage strength for Wegovy^®. For more information on eligibility and enrollment, please call 1‑833‑4‑WEGOVY (option 2).

Pharmacist:

When you apply this offer, you are certifying that you have not submitted a claim for reimbursement under any government program for this prescription, or where prohibited by law. Participation in this program must comply with all applicable laws and regulations as a pharmacy provider. By participating in this program, you are certifying that you will comply with the eligibility criteria, and terms and conditions described herein. By applying this offer, you agree that patients enrolled in a federal or state health care program may not use this program even if they elect to be processed as an uninsured (cash-paying) patient. You also certify that you will not seek reimbursement for any benefit received through this offer.

Pharmacist instructions:

• For commercially insured patients with product coverage: Submit the claim to the patient’s primary insurance first, then submit the balance due to SS&C Health as a Secondary Payer as a copay-only billing using BIN 019158 and a valid Other Coverage Code 08. The patient is responsible initially for the PALA amount, and the offer pays up to the Savings Benefit. Reimbursement will be received from SS&C Health.
• For commercially insured–not covered patients: If Wegovy^® is not covered by the patient’s insurance, continue to process the savings offer as a Secondary Payer to BIN 019158 along with the patient’s insurance using Other Coverage Code 03. The patient is responsible for the first $499 per 28-day supply (1 box), $998 per 56-day supply (2 boxes), or $1,497 per 84-day supply (3 boxes) of Wegovy^®, and reimbursement will be received from SS&C Health. 
• For patients self-paying/opting to process outside of their commercial insurance plan (which cannot be government beneficiaries, including but not limited to Medicare and Medicaid patients): Submit the claim to SS&C Health using BIN 019158 and a valid Other Coverage Code (eg, 00 or 01). The patient is responsible for the first $499 per 28-day supply (1 box), $998 per 56-day supply (2 boxes), or $1,497 per 84-day supply (3 boxes) of Wegovy^®, and reimbursement will be received from SS&C Health.
• The pharmacy must the submit claim within 180 days from the date the prescription was filled. For any questions regarding SS&C online processing, please call the Pharmacy Help Desk at 1‑844‑373‑0987.

WEGOVY^® SAVINGS SMS PROGRAM TERMS OF USE
Last Updated March 17, 2025 (effective date)

1. Agreement Generally: Acceptance. These “Terms of Use” (the “Agreement” or “Terms of Use”) are between you and Novo Nordisk’s Wegovy^® Savings SMS Program (“Wegovy^® Savings SMS Program,” “we,” “us,” or “our”). “You” means you personally. This Agreement sets forth the terms and conditions upon which we make available the Wegovy^® Savings SMS Program and its contents and offerings to you.
   
   Please note these Terms of Use govern only the Wegovy^® Savings SMS Program, and not any other service, program, or website. By participating in the Wegovy^® Savings SMS Program, you are agreeing to these Terms of Use. By using the Wegovy^® Savings SMS Program, you affirm that you are a US resident, 18 years of age or older, qualify for the Wegovy^® Savings SMS Program, and expressly consent to receive communications from Novo Nordisk or its partners in connection with the Wegovy^® Savings SMS Program. Your consent to receive marketing messages is not required for the receipt of goods or services from Novo Nordisk.
   
   For more information about data use and collection, please read the most recent version of Novo Nordisk’s Privacy Statement https://www.novonordisk-us.com/disclaimer-privacy.html. PLEASE READ THESE TERMS OF USE CAREFULLY, INCLUDING YOUR COMMUNICATION OPTIONS, BEFORE ATTEMPTING TO ENROLL IN THE WEGOVY^® SAVINGS SMS PROGRAM.
   
   IF YOU DO NOT AGREE, YOU CANNOT ENROLL IN THE WEGOVY^® SAVINGS SMS PROGRAM.
2. Eligibility. To participate in the Wegovy^® Savings SMS Program, you must be a resident of the United States and 18 years of age or older and have commercial insurance or pay cash for your prescriptions. Those with any government, state, or federally funded medical or prescription benefit coverage are not eligible for the Program. Novo Nordisk reserves the right to require you to prove that you are at least 18 years of age and your insurance coverage. Eligibility for participation in the Wegovy^® Savings SMS Program does not automatically mean that you will get any or all offerings in the Wegovy^® Savings SMS Program.
3. Modifications to Terms of Use. You agree that we may modify these Terms of Use and that such modifications shall become effective immediately upon posting of the modified Terms of Use to our website or otherwise notifying you of an update through one or more components of the Wegovy^® Savings SMS Program. If you do not accept the modifications, then you must cease using the Wegovy^® Savings SMS Program. The Terms of Use contain the date of posting at the top of the first page. Any revised version of the Terms of Use will only apply to those individuals who sign up for the Wegovy^® Savings SMS Program after the effective date. If you have previously signed up for the Wegovy^® Savings SMS Program under a prior version of these Terms of Use, you will not be required to adhere to any additions and/or requirements unless you expressly agree.
4. Permission to Use Wegovy^® Savings SMS Program; Limitations on Use of Wegovy^® Savings SMS Program. Subject to your voluntary acceptance and while you remain in compliance with the Terms of Use, we grant you a limited, revocable, non-exclusive, non-transferable license to use the Wegovy^® Savings SMS Program solely and exclusively for your own personal use and not for any other purpose. This license is solely and exclusively for your benefit. All other uses of the Wegovy^® Savings SMS Program are prohibited.
5. Communication Options. By choosing to enroll in the Wegovy^® Savings SMS Program, you consent/opt in to the option of receiving text messages from the Wegovy^® Savings SMS Program. After you complete your initial enrollment in the Wegovy^® Savings SMS by phone, you will receive a welcome text to complete your enrollment process and to further opt in to your preferred method of communication with the Wegovy^® Savings SMS Program. We do not guarantee that Wegovy^® Savings SMS Program communications will be received and are not responsible for lost or misdirected communications.
   
   To get additional Wegovy^® Savings SMS Program Support, text “HELP” to 83757 or call 1‑888‑793‑1218.
   
   To opt out of receiving text messages from Novo Nordisk or its partners related to the Wegovy^® Savings SMS Program, text “STOP” to 83757 or call 1‑888‑793‑1218.
   
   If you opt out of the Wegovy^® Savings SMS Program, any future data collection in the Wegovy Savings^® SMS Program from you will end. Any data previously collected through the Wegovy^® Savings SMS Program may be stored by Novo Nordisk. PLEASE NOTE that opting out of the Wegovy^® Savings SMS Program does not unsubscribe and/or opt you out of any future communications from Novo Nordisk or its partners that you may have previously signed up for separate and apart from the Wegovy^® Savings SMS Program. You may separately opt out of all marketing communications from Novo Nordisk, by simply clicking the “Unsubscribe” link within any email you receive from Novo Nordisk or its partners, or by calling 1‑800‑727‑6500, or clicking here, or by sending Novo Nordisk a letter containing your name, email address, and phone number, to Novo Nordisk, 800 Scudders Mill Road, Plainsboro, New Jersey 08536.
6. Text Messaging. If you choose to communicate in the Wegovy^® Savings SMS Program by text message, the following terms apply:
   1. Text Message Frequency. The Wegovy^® Savings SMS Program’s message frequency varies. Please be aware that Novo Nordisk brands and services may have separate text messaging programs. The total number of text messages you receive from Novo Nordisk or its partners, therefore, may vary based on the number of Novo Nordisk text messaging programs for which you sign up to receive messages.
   2. Cost. You will not be charged any fee from Novo Nordisk or its partners in connection with the Wegovy^® Savings SMS Program to receive coaching text messages. However, Novo Nordisk encourages you to check with your mobile service provider to see what other message and data rates may apply, including any applicable roaming charges. Novo Nordisk is not responsible for any fees or charges from any carrier or service provider related to Wegovy^® Savings SMS Program communications.
   3. Supported Carriers. The following US carriers are supported:
      1. Major Carriers: AT&T, Verizon Wireless, Sprint, and T-Mobile USA.
      2. Minor Carriers: Aio Wireless, Alaska Communications Systems (ACS), Appalachian Wireless (EKN), Bluegrass Cellular, Boost Mobile, Carolina West Wireless, CellCom, Cellular One of East Central IL (ECIT), Cellular One of Northeast Arizona, Cellular One of Northeast Pennsylvania, Chariton Valley Cellular, Cricket, Coral Wireless (MobiPCS), Cross, C-Spire (CellSouth), Duet IP (Maximum Communications New Core Wireless), Element Mobile (Flat Wireless), Epic Touch (Elkhart Telephone), GCI, Golden State, Google Voice, Hawkeye (Chat Mobility), Hawkeye (NW Missouri), Illinois Valley Cellular, Inland Cellular, iWireless (Iowa Wireless), Keystone Wireless (Immix Wireless/PC Man), Metro PCS, Mosaic (Consolidated or CTC Telecom), MTA Communications, MTPCS (Cellular One Nation), Nex-Tech Wireless, Panhandle Communications, Peoples Wireless, Pine Cellular, Pioneer, RINA, Sagebrush Cellular (Nemont), SI Wireless/Mobile Nation, Simmetry (TMP Corporation), SouthernLinc, SRT Wireless, Thumb Cellular, Union Wireless, United Wireless, U.S. Cellular, Viaero Wireless, Virgin Mobile, and West Central (WCC or 5 Star Wireless).
   4. Your Mobile Telephone Number. You represent that you are the account holder or authorized user for the mobile telephone number you opt in to receive text messages for the Wegovy^® Savings SMS Program.
   5. Access or Delivery to Mobile Network is Not Guaranteed. Delivery of information and content to a mobile device is not guaranteed and may fail due to a variety of circumstances or conditions. Alerts sent via text message may not be delivered if the mobile phone is not in range of a transmission site, or if sufficient network capacity is not available at a particular time. Even within a coverage area, factors beyond the control of the wireless carrier may interfere with message delivery, including the customer's equipment, terrain, proximity to buildings, foliage, and weather. Novo Nordisk will not be held responsible for any delays in the receipt of any text messages as delivery is subject to effective transmission from your mobile service provider or network operator. You understand and acknowledge that network services, including but not limited to mobile network services, are outside of Novo Nordisk’s control, and Novo Nordisk is not responsible or liable for issues arising from them. Note that there may be data or message fees imposed by your carrier or service provider if you choose to receive text messages from the Wegovy^® Savings SMS Program.
7. Privacy. In order to enroll in the Wegovy^® Savings SMS Program, you may provide us with your phone number. We require this information in order to communicate with you, provide you with the Wegovy^® Savings SMS Program, and to send you Wegovy^® Savings SMS Program materials. Your information will be shared between Novo Nordisk and its service providers who support the Wegovy^® Savings SMS Program in accordance with applicable laws. Novo Nordisk and its service providers may share information that does not individually identify you without restriction in accordance with applicable laws. Novo Nordisk understands and values the importance of your privacy. In accordance with these Terms of Use, Novo Nordisk may use your information for program improvements, quality monitoring, data and analytics for Novo Nordisk commercial purposes, and future Novo Nordisk marketing communications (including branded or unbranded emails, text messages, or direct mail). For more information on how we collect and use your information, please read our full Privacy Statement https://www.novonordisk-us.com/disclaimer-privacy.html.
8. Security. By enrolling in the Wegovy^® Savings SMS Program, you understand that Novo Nordisk is not a “Covered Entity” or “Business Associate” under the Health Insurance Portability and Accountability Act Privacy Rule (or “HIPAA”) that requires protection of a patient’s confidential information. By releasing your personal information to Novo Nordisk, you acknowledge that this information will not be protected by HIPAA but will be protected by reasonable security measures.
9. Content. All information available in or provided through the Wegovy^® Savings SMS Program is collectively referred to in these Terms as the “Content.” The Content may include savings offer information along with refill reminders. You may not sell, give, reproduce, create derivative works of, publicly display, or otherwise distribute the Content to anyone other than your physician(s) or caregiver(s). All rights not expressly granted herein are reserved. Novo Nordisk assumes no responsibility for the accuracy or appropriateness of any information provided by you through the Wegovy^® Savings SMS Program.
10. NOT MEDICAL ADVICE. This program does not substitute medical advice from your health care provider. You will have to contact him or her directly about issues, questions, or concerns. The Wegovy^® Savings SMS Program may provide you with communications related to savings offer eligibility, enrollment, and refill reminders. The Wegovy^® Savings SMS Program does not give medical advice. OUR CONTENT AND COMMUNICATIONS ARE NOT INTENDED TO BE A REPLACEMENT OR SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. THE CONTENT AND COMMUNICATIONS DO NOT CONSTITUTE MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. YOU ACKNOWLEDGE AND UNDERSTAND THAT YOU WILL SEEK THE ADVICE OF A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER WITH ANY QUESTIONS THAT ARISE REGARDING ANY MEDICAL CONDITION. YOU ACKNOWLEDGE THAT ALL INFORMATION AND GUIDANCE PROVIDED BY YOU IS SOLELY AT YOUR OWN RISK. You understand that Novo Nordisk does not endorse any particular physician or health care provider for the treatment of any specific medical condition. You further understand that this program is not a means to communicate product issues or negative side effects to Novo Nordisk. You are encouraged to report negative side effects of prescription drugs to the FDA at www.fda.gov/medwatch, or by phone at 1‑800‑FDA‑1088. Novo Nordisk is not responsible for monitoring or recording text messages that may constitute an issue or negative side effect. However, if you are using a Novo Nordisk Product as treatment, and some of your entered responses can be interpreted as a side effect of the medication, Novo Nordisk reserves the right to contact you for more information by phone or written communication. For additional information about your medication, please call Novo Nordisk Customer Care at 1‑833‑693‑6742.
11. Prohibited Activity. You will not: (a) access or attempt to access the Wegovy^® Savings SMS Program or any part thereof that you are not authorized to access or through any means that you are not authorized to use; (b) disrupt or interfere with the security of, or otherwise cause harm to the Wegovy^® Savings SMS Program, systems, resources, accounts, passwords, servers or networks connected to or accessible through the Wegovy^® Savings SMS Program or any affiliated or linked websites or access or use the Wegovy^® Savings SMS Program in any manner that could damage, disable, overburden, or impair any server or network used by us in connection with the Wegovy^® Savings SMS Program; (c) use the Wegovy^® Savings SMS Program to transmit any information of a sensitive nature, such as health information, Social Security numbers, credit card numbers (other than as strictly allowed), or any other information that, if generally exposed, could lead to identity theft, financial fraud, embarrassment, or other harm; (d) use the Wegovy^® Savings SMS Program in any manner that infringes upon or violates any intellectual property rights or other rights or interest of any party or otherwise constitutes pornography, defamation, harassment, bullying, predatory behavior, false and deceptive advertising, or hate speech; (e) submit any software, programs, or files via the Wegovy^® Savings SMS Program that are harmful or disruptive of another’s equipment, software, or other property, including any corrupted files, time bombs, Trojan Horses, viruses, and worms; (f) disrupt, interfere with, or inhibit any other user from using and enjoying the Wegovy^® Savings SMS Program; (g) violate any applicable laws or regulations related to the access to or use of the Wegovy^® Savings SMS Program, and/or engage in any activity prohibited by the Terms of Use; (h) compile, use, download, or otherwise copy any materials available on the Wegovy^® Savings SMS Program (except as expressly permitted), or transmit, provide, or otherwise distribute (whether or not for a fee) such materials to any third party; (i) use, or allow anyone else to use, any robot, spider, or other such programmatic or automatic device, including but not limited to automated dial-in or inquiry devices, to obtain information from the Site or otherwise monitor or copy any portion of the Wegovy^® Savings SMS Program; (j) frame, mirror, or use framing techniques on any part of the Wegovy^® Savings SMS Program without our express prior written consent; (k) make any use of, or allow anyone else to make any use of, data extraction, scraping, mining, or other data gathering tools, or create a database by systematically downloading or storing the Wegovy^® Savings SMS Program, or any portion thereof, or otherwise scrape, collect, store, or use the Wegovy^® Savings SMS Program, except pursuant to the limited license granted by the Terms of Use; (l) modify, adapt, translate, reverse engineer, decompile, or disassemble any portion of the Wegovy^® Savings SMS Program; or (m) remove any copyright, trademark, or other proprietary rights notice from the Wegovy^® Savings SMS Program. These examples of prohibited conduct are illustrative and are not exhaustive.
    
    TO THE MAXIMUM EXTENT AUTHORIZED BY LAW WE RESERVE THE RIGHT, BUT DISCLAIM ANY OBLIGATION WHATSOEVER, TO MONITOR OUR SITE AND YOUR COMPLIANCE WITH THIS SECTION AND WITH THE TERMS OF USE AS A WHOLE.
12. Termination of Wegovy^® Savings SMS Program. Novo Nordisk may suspend or terminate your use of the Wegovy^® Savings SMS Program if Novo Nordisk believes you are in breach of these Terms of Use. Your receipt of Wegovy^® Savings SMS Program communications is also subject to termination in the event that your telephone or network service terminates or lapses. Novo Nordisk reserves the right to modify or discontinue, temporarily or permanently, all or any part of the Wegovy^® Savings SMS Program with or without notice. You assume sole responsibility for the proper use and scheduling of any medications, treatments, and procedures related to your health care and disease management.
13. Assignment. You may not assign any of your rights or obligations hereunder, whether by operation of law or otherwise, without our prior written consent. Notwithstanding the foregoing, we may freely assign the Terms of Use, and the rights and obligations therein, without your consent, including, but not limited to, in connection with a merger, acquisition, corporate reorganization, or sale of all or substantially all of our assets. Subject to the foregoing, the Terms of Use shall bind and inure to the benefit of the parties, their respective successors and permitted assigns.
14. Entire Agreement. This Agreement, including the documents incorporated herein by reference, is the entire understanding and agreement between Wegovy^® Savings SMS Program and you with respect to the subject matter hereof.
15. Miscellaneous. The invalidity or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision. To the event that any provision of this Agreement is found to be invalid or unenforceable, this Agreement shall be construed in accordance with its terms as if the invalid or unenforceable provision was not contained therein. No delay or failure by Wegovy^® Savings SMS Program to enforce any provision of this Agreement shall be a waiver of any of our rights under this Agreement.