To submit a rebate claim you will need:
Please note: You may only submit a claim if you have commercial insurance or are self-insured (e.g., cash-paying), and you are not a participant of Medicare Part D, VA, TriCare, CHAMPUS, Medicaid, or any other similar federal or state program nor have you made payment using any federal or state tax-exempt account (e.g., HSA, FSA, or HRA). See Eligibility Criteria for details.