Receive 99 FREE* CONTOUR®NEXT blood glucose meters for your patients, all you have to do is:
Ascensia respects your right to privacy. Your personal and medical information will be kept confidential. It will not be shared with any third parties or outside mailing lists.
Thank you for choosing CONTOUR® NEXT Blood Glucose Meters
Use this coupon to give your patients CONTOUR® NEXT blood glucose meters FREE!
To the Pharmacist:
This coupon is part of the Ascensia Diabetes Care Free Meter Program.
This coupon must be accompanied by a valid prescription. If none on file, please contact the physician.
Please dispense one CONTOUR® NEXT meter at no charge to the patient.Transmit the claim on-line to OPTUMRx.
This coupon is valid for one fill only, and refills will not be authorized.
Process requires Valid Prescriber ID#, Patient Name, and DOB to adjudicate claim.
Please remove the ID# from the patient profile after the claim is processed.
For assistance in filing this claim, please contact the help desk at 1-800-510-4836.
Claim for product dispensed pursuant to this coupon shall be submitted to OPTUMRx ONLY for reimbursement and not to Medicare, Medicaid or any third-party payer.
Any use of this coupon other than as indicated constitutes fraud. Failure to produce to Ascensia Diabetes Care, on request, invoices and other information demonstrating that all conditions have been met, will void all coupons submitted and you must repay Ascensia Diabetes Care all money received for all coupons under this program. Ascensia Diabetes Care reserves the right to withhold payment if it believes terms have not been met. Incomplete submissions may not be processed. This is a no charge meter and may not be billed to Medicare, Medicaid or any third-party insurance. This meter is not eligible for any Ascensia Diabetes Care Manufacturer's mail-in rebate/trade-in offer and you must produce a $0.00 receipt for patient. Coupon may not be reproduced.
*Limitations and restrictions apply. Limit one meter per person. Void where prohibited by law. Offer not valid for prescriptions reimbursed under Medicaid, Medicare drug benefit plan, Tricare or other federal or state health programs (i.e. medical assistance programs). If patient is eligible for drug benefits under any such program, offer not valid.