Patient: Take your BENSAL HP® prescription to your pharmacy along with this offer (Remember this offer is only good for BENSAL HP). Most commercially insured patients will pay no more than a $35 out-of-pocket copay for each BENSAL HP prescription fill (after primary insurance and this rebate card). Patients are solely responsible for complying with the terms of their insurance. Cash paying patients will be provided a maximum benefit available paid by the manufacturer. Any remaining balance for the prescription will be the patient's responsiblity. Retain this card for future use with available fills.

Patients with questions should call 800-657-7613.

The Savings Card is redeemable only when accompanied by a valid prescription.

Click button to print Savings Card

Not valid for patients reimbursed by federal health care programs, including Medicare, Medicaid, TRICARE, CHAMPVA, the Department of Veterans Affairs, state maternal and child health block grant programs under 42 U.S.C. 701 et. seq., state social service block grant programs under 42 U.S.C. section 1397 et. seq. or any other similar federal or state healthcare program. Void where prohibited by law, taxed or restricted. Void outside the United States. Patient is responsible for reporting receipt of card program rewards to any private insurer that pays for or reimburses any part of the prescriptions filled with this card. Void if reproduced. It is illegal for any person to sell, purchase, or trade, or offer to sell, purchase or trade, or to counterfeit this card.

SMG Pharmaceuticals reserves the right to rescind, revoke or amend this offer at any time.