Harrow Access

I have commercial insurance

By downloading this card you are verifying that you have commercial insurance and do NOT have Medicare Part D or Medicare Advantage. You also verify that your prescriptions are NOT paid for in part or full by any federally funded program, including Medicare, Medicaid, Tricare, DOD, and VA.

By checking this circle, I consent to receive a text message to the phone number provided that will contain my Harrow coupon savings card information, savings alerts, and refill reminders. Message and data rates may apply. Message frequency varies. You can opt out of texting at any time by replying STOP. Text HELP for help. See Terms and Conditions, and Privacy Policy.

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Terms and Conditions:

For patients whose prescriptions are covered by commercial insurance, use of this card may reduce your copayment so that you may pay as little as $0 for (VEVYE, VERKAZIA, and NATACYN).
For patients whose prescriptions are covered by commercial insurance, use of this card may reduce your copayment so that you may pay as little as $59 for (TOBRADEX ST, FLAREX, ZERVIATE, VIGAMOX, and ILEVRO).
For patients whose prescriptions are not covered by commercial insurance, use of this card may reduce your cost for prescriptions to as little as $59 for (TOBRADEX ST, FLAREX, ZERVIATE, VIGAMOX, and ILEVRO).
This card is not valid for prescriptions paid for in part or full by Medicare, Medicaid, Tricare, DOD, VA, or any state or federally funded program.
This offer shall be applied only toward the cost of an eligible prescription product and not toward ancillary services or treatment costs.
This offer is only good in the United States of America (including the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands).
You must present this coupon along with your prescription to participate in this program.
This offer is not health insurance.
The selling, trading, or counterfeiting of this coupon is prohibited by law. Void if reproduced.
This offer is not transferable.
When you use this offer, you are certifying that you understand and agree to comply with the program rules, regulations, eligibility requirements, and Terms and Conditions.
Harrow reserves the right to rescind, revoke, or amend this offer at any time.

For questions call: 1-316-219-4495

One more step!

You have successfully enrolled in the Harrow Savings Program and we are generating your card. Print it now, and then present it to your pharmacist when you fill your prescription.

Present this card to your pharmacist when you fill your prescription.

RxBIN:

RxPCN:

RxGRP:

Card ID:

Customer Care:

316-219-4495

Terms and Conditions:

For patients whose prescriptions are covered by commercial insurance, use of this card may reduce your copayment so that you may pay as little as $0 for (VEVYE, VERKAZIA, and NATACYN).
For patients whose prescriptions are covered by commercial insurance, use of this card may reduce your copayment so that you may pay as little as $59 for (TOBRADEX ST, FLAREX, ZERVIATE, VIGAMOX, and ILEVRO).
For patients whose prescriptions are not covered by commercial insurance, use of this card may reduce your cost for prescriptions to as little as $59 for (TOBRADEX ST, FLAREX, ZERVIATE, VIGAMOX, and ILEVRO).
This card is not valid for prescriptions paid for in part or full by Medicare, Medicaid, Tricare, DOD, VA, or any state or federally funded program.
This offer shall be applied only toward the cost of an eligible prescription product and not toward ancillary services or treatment costs.
This offer is only good in the United States of America (including the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands).
You must present this coupon along with your prescription to participate in this program.
This offer is not health insurance.
The selling, trading, or counterfeiting of this coupon is prohibited by law. Void if reproduced.
This offer is not transferable.
When you use this offer, you are certifying that you understand and agree to comply with the program rules, regulations, eligibility requirements, and Terms and Conditions.
Harrow reserves the right to rescind, revoke, or amend this offer at any time.

Pharmacist Instructions:

For Commercially Insured Patients

Submit the claim to the primary commercial insurance company.
Submit the balance due as a Secondary Submission COB with the patient responsibility amount and a valid Other Coverage Code (OCC).
For eligible commercial patients when the product is covered, submit BlN and OCC 08. For eligible commercial patients when the product is not covered, submit BlN and OCC 03.

Program Terms and Conditions

When you process this card, you certify that you have read, understood, and are in compliance with the terms and conditions pertaining to this program. You are further certifying that you have not submitted and will not submit a claim for reimbursement under Medicare or similar federal or state programs including any state medical pharmaceutical assistance program for this prescription.
The Harrow Copay Savings Program card is not valid for use with any other prescription drug discount or cash cards for FLAREX^®, TOBRADEX^® ST, ZERVIATE^®, VEVYE^®, VIGAMOX^®, ILEVRO^®, VERKAZIA^®, NATACYN^®. Claims submitted utilizing the program are subject to audit or validation.
Harrow reserves the right to rescind, revoke, or amend this offer at any time.

For questions call: 1-316-219-4495