PROGRAM TERMS AND CONDITIONS

Terms & Conditions:

These Terms & Conditions and use of the services is subject to payment of an annual membership fee¹ and the following terms and conditions. Please read these terms and conditions carefully before completing your registration for the services, so that you fully understand your rights and responsibilities.

Disclosures:

This discount program is NOT HEALTH INSURANCE and is not intended as a substitute for insurance. This program provides savings on a select group of prescription medications purchased from participating pharmacies. This program is administered by Medical Security Card Company (MSC), LLC, 4911 E. Broadway Boulevard, Tucson, AZ 85711, 1-800-700-39571-800-700-3957, www.scriptsave.com and is marketed by your participating pharmacy. This program is not available in all state. This program does not make payments directly to any provider. You are obligated to pay for all services at the time of the service. This program is governed by the terms and conditions outlined on this enrollment form. MSC is not responsible for providing or guaranteeing service or for the quality of services rendered. Participating pharmacies are subject to change without notice and are not available in all areas. Prescriptions paid for in whole or in part by publicly funded health care programs, such as Medicare and Medicaid, are ineligible. Membership discounts cannot be combined with any insurance.

Fees & Term of Agreement:

An annual membership fee of $5.00 per household is payable at time of enrollment and the program is effective immediately upon receipt of enrollment fee and signed enrollment form.

Membership:

The yearly enrollment fee of $5 provides you and your entire household all of the features of My Prescription Savings Card.

Program Features:

To obtain discounts, present your membership card at a participating pharmacy before you pay for any prescription drugs. The My Prescription Savings Card provides you with savings on select generic and brand medications. The prices for these medications are based on whether it is a 30-day supply² or 90-day supply² and its pricing level:

• Level 1: $4 for a 30-day supply and $10 for a 90-day supply
• Level 2: $5 for a 30-day supply and $14 for a 90-day supply
• Level 3: $10 for a 30-day supply and, $24 for a 90-day supply
• Level 4: $15 for a 30-day supply and $35 for a 90-day supply

With My Prescription Savings Card you will also receive discounts on other generic and brand name medications, immunization discounts, and discounts on select human-equivalent pet medications.

Cancellation:

You may cancel your membership in this program at any time. To cancel your membership in this program, contact your local pharmacy and inform them of your choice to no longer participate in the My Prescription Savings Card.

Contacting Us:

If you have questions about this program, please contact your participating pharmacy or call  1-866-223-9675 1-866-223-9675.

• Membership fee does not apply in CA, UT and WA; the program is effective upon receipt of signed enrollment form.
• The day supply is based upon the average dispensing patterns for the specific drug and strength. The Program, as well as the prices and the list of covered drugs can be modified at any time without notice.