Copay tool v3

My Co-pay

One box of FlexPen^® provides
50% more insulin than a vial for the same
co-pay on most managed care plans

For further savings...

Regardless of your plan’s co-pay, you may be eligible for savings that last with the Novo Nordisk Instant Savings Card:

Pay no more than $25 a fill for up to 2 years when you start on a Novo Nordisk product*
Pay no more than $20 a fill for select other Novo Nordisk products, if added to your care plan, for up to 2 years*
You may also be eligible for a FREE box of Novo Nordisk needles†

You'll also automatically be enrolled in our diabetes support program, Cornerstones4Care^®, when you sign up. *Restrictions apply.
†Needles are sold separately and may require a prescription in some states.

More information by mail?

When you sign up to learn more about FlexPen^®, you'll receive a free kit in the mail and automatically be enrolled in our diabetes support program, Cornerstones4Care™.

Policyholder: /

Patient:

Prescription:

Member ID:

Rx Group ID:

Rx BIN #:

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Formulary data are provided by Fingertip Formulary® and are current as of January 2015. Because formularies do change and many health plans offer more than one formulary, please check directly with the health plan to confirm coverage. Intended as a guide. Lower acquisition costs alone do not necessarily reflect a cost advantage in the outcome of the condition treated because there are other variables that affect relative costs. Formulary status is subject to change.