*Eligibility Criteria, Terms and Conditions: This offer is only valid for patients with commercial insurance, including commercially-insured patients without coverage for Xifaxan. Patients without commercial insurance are not eligible. Commercially-insured patients with coverage for Xifaxan will receive savings to reduce their copay to as little as $0. Commercially-insured patients without coverage for Xifaxan will receive savings off of retail price to reduce the out-of-pocket cost to as little as $50. Maximum benefits and number of uses apply. For information about the maximum benefits and number of uses please visit www.xifaxan.com and/or call the helpline 1-866-XIFAXAN (option 1). Patient is responsible for all additional costs and expenses after application of the maximum benefits. You must activate this coupon before using it by visiting Xifaxan.com, calling 1-866-XIFAXAN, or texting PAYZERO to 24109. Message and data rates may apply. The full terms can be viewed at https://copaysavingsprogram.com/110/Xifaxan/sms-terms. This offer is not valid for any person eligible for reimbursement of prescriptions, in whole or in part, by any federal, state, or other governmental programs, including, but not limited to, Medicare (including Medicare Advantage and Part A, B, and D plans), Medicaid, TRICARE, Veterans Administration or Department of Defense health coverage, CHAMPUS, the Puerto Rico Government Health Insurance Plan, or any other federal or state health care programs. This offer is only good in the USA at participating retail pharmacies. This offer cannot be redeemed at other locations, including government-subsidized clinics or facilities. This offer is not valid where otherwise prohibited, taxed, or otherwise restricted. Patient is responsible for reporting receipt of co-pay assistance to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the co-pay card, as may be required. This offer cannot be combined with other offers. This card has no cash value. No other purchase is necessary. This offer is nontransferable. No substitutions are permitted. This card is not health insurance. You understand and agree to comply with the terms and conditions of this offer as set forth above. Salix Pharmaceuticals reserves the right to rescind, revoke, or amend this offer at any time without notice. This offer expires on December 31, 2019.
XIF.0172.USA.18