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Senseonics, Incorporated | 20451 Seneca Meadows Parkway • Germantown, MD 20876-7005
TERMS AND CONDITIONS
The Eversense Bridge Program (“Program”) is offered by Senseonics, Incorporated (“Senseonics”), the manufacturer of the Eversense CGM System (“Eversense System” or “Eversense CGM”), and managed by our contracted Program partner(s). Eligible patients may receive assistance up to the Program maximum, payable to the furnishing supplier/distributor, in two (2) separate instances of purchasing Eversense product(s). Because the Program does not apply to sensor placement/removal procedures, such procedures remain the responsibility of the patient who should discuss the additional costs of the procedure(s) with their physician. This offer may not be redeemed for cash or anything else of value. To receive assistance under the Program, patients must certify they meet the Eligibility Requirements, and shall only participate in the Program to gain access to Eversense products. The Program is being offered for a limited time period, to be determined by Senseonics. Each participating patient must consent to their personal and health data being received, accessed, and/or shared by and between Senseonics and our contracted Program partners, solely for purposes of operating the Program for the patient (which includes access assistance in (i) obtaining Eversense products, and (ii) insurance coverage determinations through pre-authorization and appeal submissions).
The Eversense Bridge Program (“Program”) offers monetary assistance to obtain the Eversense CGM System, to patients who meet the Eligibility Requirements and make an initial $99 payment towards purchasing Eversense product(s). To be eligible for the Program, patients must: (i) be 18 years or older and have a valid prescription for the Eversense CGM System; (ii) have a commercial or private insurance plan that does not cover the full costs of the Eversense System; (iii) not be enrolled in any state or federal health program (such as Medicare, Medicaid, Medicare Advantage, any Medicaid managed care plan, Veterans Affairs (VA), Department of Defense (DOD) programs or TRICARE); and (iv) not be a resident of Massachusetts. Other rules and restrictions apply.
The Program does not represent or constitute insurance of any kind; participating patients must, to the extent necessary, report the receipt of Program assistance to their existing insurance payer or plan. The monetary assistance under the Program is non-transferable, limited for each eligible patient to two (2) instances of acquiring the Eversense product(s), and may not be combined with any other offer (except as specifically approved in advance by Senseonics). By participating in this Program, each patient agrees that he or she understands and meets the Eligibility Requirements and agrees to the Terms and Conditions. Senseonics (either directly or through a contracted Program partner) reserves the right to rescind, revoke, or amend this Program without notice at any time. The Program is void where prohibited; rules and restrictions apply.