A representative from a specialty pharmacy may contact you about your LILETTA® payment. Make sure to provide the card number (example: LILXXXXXXXX) and the Rx BIN# 014310 listed on your card.
No, the card may only be used towards the cost of the LILETTA product itself.
You can call 1.855.706.4508 between 9 am—8 pm ET, Monday through Friday to obtain your account number over the phone.
If you paid your financial responsibility for LILETTA at the time of insertion, visit LILETTAcard.com to apply for the program and download a rebate request form. Once completed, submit your rebate request form along with your Explanation of Benefits to LILETTAcard.com or via fax at 1.888.683.4991. As per Program Terms, Conditions, and Eligibility Criteria for the LILETTA Savings Program, to be eligible for participation you must submit the EOB within 60 days of LILETTA insertion.
No. You are required to apply for participation in each program separately. If you are an eligible patient who enrolled in the LILETTA + LILETTA Patient Commitment Program® on or before October 31, 2018, please call 1-855-706-4508 for questions or information about your enrollment.
This program has been discontinued, effective November 1, 2018. Participation is still valid through October 31, 2022 for eligible patients who enrolled in the program on or before October 31, 2018. If you are an eligible patient who enrolled in the LILETTA + LILETTA Patient Commitment Program® on or before October 31, 2018, please call 1-855-706-4508 for questions or information about your enrollment.
For the LILETTA® Help Desk, call 1.855.706.4508. Our fax number is 1.888.683.4991. We are available to answer questions from 9 am—8 pm ET, Monday through Friday, except for the following holidays:
New Year's Day
Independence Day Holiday
LILETTA® (levonorgestrel-releasing intrauterine system) 52 mg is a hormone-releasing system placed in your uterus to prevent pregnancy for as long as you want for up to 5 years.
LILETTA does not protect against HIV or STDs.
Available by prescription only.
Please see full Prescribing Information.
Reference: 1. LILETTA (levonorgestrel-releasing intrauterine system) 52 mg [Prescribing Information]. Irvine, CA: Allergan and Medicines360; 2018.