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"My monthly prescription bill dropped from $105 to $84. We don't have health insurance, and this is savings we can use—without a monthly card fee." -D. Peterson
Please fill out the form below to receive your temporary Prescription Savings Card. Please review the FAQ section for additional information.
fields and must be filled out.
This card will work for your entire family,
you do not
need to fill out multiple forms for each family member.
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