![GARDASIL [Human Papillomavirus Quadrivalent(Types 6, 11, 16, and 18) Vaccine, Recombinant]](resources/images/templates/gardasil.gif)
Questions About Patient Eligibility (2011 Terms and Conditions)
Questions About the Administration of the Dose of GARDASIL
Questions About the Rebate Request Form
Questions About the Rebate
Questions About the Explanation of Benefits (EOB) Document
Questions About the 2011 Terms and Conditions
Questions About the Status of the Rebate
Questions About the Third-Party Administrator
General Questions About the Program
You [your son/daughter] must be between the ages of 19 and 26 when the dose of GARDASIL is administered to be eligible to receive the rebate.
Back to topYes. Male patients who are between the ages of 19 and 26 when the dose of GARDASIL is administered are eligible to receive the rebate. The dose must be administered between January 1, 2011, and December 31, 2011, and all other 2011 Terms and Conditions must be met for the new 2011 Patient Rebate Program for GARDASIL.
If their dose of GARDASIL was administered between January 1, 2011, and December 31, 2011, patients must submit the correct rebate request form (a yellow form) that indicates that the patients are eligible to receive the rebate.
Back to topYou [your son/daughter] must have private health insurance at the time the dose of GARDASIL is administered to be eligible for the rebate.
The rebate is not valid for uninsured patients or patients covered by Medicaid, Medicare, a Medicare Part D Advantage plan (regardless of whether a specific prescription is covered), TRICARE, CHAMPUS, or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program.
Back to topYou are [your son/daughter is] not eligible for the rebate if you are [he/she is] uninsured. You [your son/daughter] must have private health insurance at the time the dose of GARDASIL is administered to be eligible for the rebate.
Back to topThe Patient Rebate Program for GARDASIL is for patients with private health insurance.
GARDASIL is available through the Merck Vaccine Patient Assistance Program for qualified patients.
You can learn more about the Merck Vaccine Patient Assistance Program at merckhelps.com or by calling 1-800-293-3881, 8:00 AM-8:00 PM ET, Monday through Friday, where a Patient Assistance Program specialist will be available to assist you.
Back to topThe rebate is not valid for uninsured patients or patients covered by Medicaid, Medicare, a Medicare Part D Advantage plan (regardless of whether a specific prescription is covered), TRICARE, CHAMPUS, or any other state or federal medical or pharmaceutical benefit program or pharmaceutical assistance program.
Back to topYes, you [your son/daughter] must be a resident of the United States and the dose of GARDASIL must be administered in the United States to be eligible for the rebate.
However, you [your son/daughter] must not be a resident of Massachusetts. If a person other than the patient is responsible for the out-of-pocket cost for GARDASIL, neither the patient nor the person responsible for the out-of-pocket cost may be a resident of Massachusetts.
Back to topThe Patient Rebate Program is not available to residents of Massachusetts because of state restrictions.
Back to topNo. If you are [your son/daughter is] a resident of Puerto Rico or the United States territories, you are [he/she is] not eligible for the rebate. You [your son/daughter] must be a resident of the United States and the dose of GARDASIL must be administered in the United States to be eligible for the rebate. If a person other than the patient is responsible for the out-of-pocket cost of the dose, this person must be a resident of the United States to be eligible for the rebate.
Back to topNo. You [your son/daughter] must be a resident of the United States and the dose of GARDASIL must be administered in the United States to be eligible for the rebate.
Back to topNo, children between the ages of 9 and 18 are not eligible for the rebate. Only patients who are between the ages of 19 and 26 when the dose of GARDASIL is administered are eligible to receive the rebate.
Back to topYes, both the patient and the person responsible for the out-of-pocket cost for GARDASIL must be residents of the United States and the dose of GARDASIL must be administered in the United States to be eligible for the rebate.
Back to topNo, you [your son/daughter] must be between the ages of 19 and 26 when the dose of GARDASIL is administered to be eligible to receive the rebate.
Back to topAs long as each of your children is between the ages of 19 and 26 when the dose of GARDASIL is administered and all other 2011 Terms and Conditions are met, they are each eligible to receive the rebate.
An original completed rebate request form and a copy of either the patient's or health care provider's Explanation of Benefits (EOB) document (that indicates the out-of-pocket cost of the dose to be more than $30) must be submitted for each child.
Back to topFor patients between the ages of 19 and 26, the dose of GARDASIL must be administered between January 1, 2011, and December 31, 2011, to be eligible for the rebate under the 2011 Terms and Conditions of the new 2011 Patient Rebate Program for GARDASIL. Doses administered before January 1, 2011, may be eligible for a rebate under the 2010 Terms and Conditions of the 2010 Patient Rebate Program for GARDASIL. Your doctor should have provided you with the correct form based on the date of administration. The 2010 rebate request form is a red form and the 2011 rebate request form is a yellow form.
Back to topYes, the dose of GARDASIL must be administered in the United States to be eligible for the rebate.
Back to topThe "Patient Certification" section of the rebate request form is filled out and signed by the patient who received the dose of GARDASIL on the date indicated in the "Health Care Professional Certification" section of the form.
Back to topYou [your son/daughter] must provide all information requested on the rebate request form and must sign and date the patient certification.
Rebate request forms that are not filled out completely or are modified will not be eligible for a rebate.
We need your [son/daughter's] birthdate to verify that you were [he/she was] between the ages of 19 and 26 when the dose of GARDASIL was administered.
We need your [son/daughter's] phone number in case we need to contact you [him/her] to verify any of your [his/her] information as we process the request for a rebate.
Back to topThe "Primary Insured Certification" section of the rebate request form is filled out and signed by the person responsible for the out-of-pocket cost for the dose of GARDASIL administered to the patient listed on the form.
This person could be the patient if the private health insurance is in the patient's name and the patient is personally responsible for the out-of-pocket cost, or someone else (such as a parent, legal guardian, or spouse) if the private health insurance is not in the patient's name.
Back to topThe person responsible for the out-of-pocket cost for the dose of GARDASIL must provide all information requested on the rebate request form and must sign and date the "Primary Insured Certification."
Rebate request forms that are not filled out completely or are modified will not be eligible for a rebate.
We need the phone number of the person responsible for the out-of-pocket cost in case we need to contact him or her to verify any of the health insurance information as we process the request for a rebate.
Back to topRebate request forms that are modified or have sections of the 2011 Terms and Conditions or Certifications blacked out will not be eligible for a rebate.
Back to topWhile either a licensed doctor or health care professional or a qualified employee acting on his or her direction (such as a nurse) may administer the dose of GARDASIL, the "Health Care Professional Certification" section of the rebate request form can only be signed by the licensed doctor or health care professional (such as a nurse practitioner or physician assistant).
This section cannot be signed by a registered nurse.
This section cannot be filled out by the patient or the person responsible for out-of-pocket cost for the dose of GARDASIL.
Back to topNo, you [your son/daughter] or the person responsible for the out-of-pocket cost for the dose of GARDASIL cannot complete the "Health Care Professional Certification" section of the rebate request form on your [his/her] doctor's behalf.
While either a licensed doctor or health care professional or a qualified employee acting on his or her direction (such as a nurse) may administer the dose of GARDASIL, the "Health Care Professional Certification" section can only be signed by the licensed doctor or health care professional (such as a nurse practitioner or physician assistant).
This section cannot be signed by a registered nurse.
If this section is incomplete or missing a signature, you [your son/daughter] or the person responsible for the out-of-pocket cost for the dose of GARDASIL must bring the rebate request form back to the doctor's office to have this section completed in order to be eligible for the rebate.
Back to topThe licensed doctor or health care professional who administered the dose of GARDASIL must sign the "Health Care Professional Certification" section of the rebate request form with an original signature. Stamped signatures are not accepted.
If the doctor or health care professional used a stamp signature for this section, you [your son/daughter] or the person responsible for out-of-pocket costs for GARDASIL must bring the rebate request form back to the doctor's office to have this section signed with an original signature in order to be eligible for the rebate.
Back to topMail the original completed rebate request form and a copy of either the patient's or health care provider's Explanation of Benefits (EOB) document you received from your private health insurance company (that indicates the out-of-pocket cost of the dose of GARDASIL to be more than $30) to:
Patient Rebate Program for GARDASIL
PO Box 748
Horsham, PA 19044
As a reminder, rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topThe original completed rebate request form and a copy of either the patient's or health care provider's Explanation of Benefits (EOB) document received from your private health insurance company (that indicates the out-of-pocket cost of the dose of GARDASIL to be more than $30) must be postmarked within 120 days after the date of administration of the dose to be eligible for the rebate.
Rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topTo be eligible for the rebate, you [your son/daughter] must submit an original rebate request form and a copy of either the patient's or health care provider's Explanation of Benefits (EOB) document received from your private health insurance company (that indicates the out-of-pocket cost of the dose of GARDASIL to be more than $30).
Photocopies of the rebate request form are not accepted. However, photocopies of the patient's EOB are accepted.
Back to topIf you [your son/daughter] misplaced the rebate request form, a new form must be obtained from the doctor or health care processional who administered the dose of GARDASIL.
As a reminder, rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topRebate request forms are only available through your [son/daughter's] licensed doctor or health care professional.
Your doctor or health care professional can visit gardasilrebate.com or call 1-800-GARDASIL to learn more about the Program.
Back to topYour doctor or health care professional can visit gardasilrebate.com or call 1-800-GARDASIL to learn more about the Program.
Back to topFor doses administered to male patients in 2010, male patients must submit the correct rebate request form. It is a red form and indicates that male patients are eligible to receive the rebate, subject to the 2010 Terms and Conditions and other eligibility criteria.
Male patients are not eligible for the rebate if the submission includes a rebate request form that indicates only female patients are eligible to receive the rebate (a blue form).
Now, for doses administered in 2011, male and female patients requesting a rebate should submit the yellow rebate request form.
If you have [your son has] the incorrect rebate request form, the correct form must be obtained from the doctor or health care professional who administered the dose of GARDASIL.
Back to topIt typically takes 6 to 8 weeks to process the rebate.
Back to topThe rebate is limited to the amount the private health insurance company indicates on the Explanation of Benefits (EOB) document that the patient or the person responsible for the out-of-pocket cost is obligated to pay for the dose of GARDASIL minus $30, up to a maximum of $130. The maximum rebate for each dose is $130, regardless of the amount the patient or the person responsible for the out-of-pocket cost for the dose actually paid or is obligated to pay.
Back to topThe rebate is valid for the out-of-pocket cost for the dose of GARDASIL only. The rebate is not valid for any other products or other out-of-pocket costs (for example, office visit charges, office visit co-payments, or vaccine administration charges) even if such costs are associated with the administration of the dose of GARDASIL.
Back to topNo, the rebate is not valid for any other products or other out-of-pocket costs (for example, office visit charges, office visit co-payments, or vaccine administration charges) even if such costs are associated with the administration of the dose of GARDASIL.
The rebate is valid for the out-of-pocket cost for the dose of GARDASIL only.
Back to topNo, your [son/daughter's] doctor or health care professional may not request the rebate on your [son/daughter's] behalf. Only the patient or the person responsible for the out-of-pocket cost for the dose of GARDASIL may request the rebate.
Back to topNo, your [son/daughter's] doctor or health care professional may not receive the rebate directly from Merck. Only the person responsible for the out-of-pocket cost for the dose of GARDASIL may receive the rebate.
The patient or the person responsible for the out-of-pocket cost remains obligated to pay the doctor or health care professional for the dose of GARDASIL.
Back to topIf your parent/legal guardian is responsible for the out-of-pocket cost for the dose of GARDASIL, he or she may request and receive the rebate. Your parent/legal guardian will fill out, sign, and date the "Primary Insured Certification" section of the rebate request form.
You will still need to fill out, sign, and date the "Patient Certification" section of the rebate request form.
The rebate check will be mailed directly to the person responsible for the out-of-pocket cost (in this case, your parent/legal guardian).
Back to topNo, the rebate check will be mailed directly to the person responsible for the out-of-pocket cost for the dose of GARDASIL (in this case, your parent/legal guardian) as listed in the "Primary Insured Certification" section of the rebate request form.
Back to topThe rebate is limited to the amount the private health insurance company indicates on the Explanation of Benefits (EOB) that the patient or the person responsible for the out-of-pocket cost is obligated to pay for the dose of GARDASIL minus $30, up to a maximum of $130. The maximum rebate for each dose is $130, regardless of the amount the patient or the person responsible for the out-of-pocket cost for the dose actually paid or is obligated to pay.
If the EOB document indicated an out-of-pocket amount of $30 or less for the dose of GARDASIL you will not be eligible for a rebate and should not submit a rebate request form.
If the EOB document indicated an out-of-pocket amount of more than $30 but less than $160, the rebate would be that amount less $30. For example, if the patient's EOB listed an out-of-pocket cost for the dose of GARDASIL at $75, the rebate would be $45.
If the EOB document indicated an out-of-pocket amount equal to or greater than $160, the rebate would be $130, the maximum amount. For example, if the patient's EOB listed an out-of-pocket cost for the dose of GARDASIL as $175, the rebate would be $130.
Back to topYes, the rebate check can be sent to a Post Office Box.
Back to topThe rebate check will be mailed via United States Postal Service.
Back to topNo, no one will need to sign for the delivery of the rebate check. The rebate check will be mailed via United States Postal Service.
Back to topYou [your son/daughter] may be responsible for reporting receipt of the rebate to your [his/her] private health insurance company or any other third party that pays for or reimburses any part of the costs associated with the administration of the dose of GARDASIL for which you are [he/she is] seeking this rebate.
Please check with your [his/her] private health insurance company to learn if you [he/she] must report receipt of the rebate.
Back to topThe Patient Rebate Program for GARDASIL was created to help with the out-of-pocket cost for the dose of GARDASIL for eligible patients with private health insurance, not to eliminate the out-of-pocket cost or provide GARDASIL for free.
Back to topIf the Explanation of Benefits (EOB) indicates that there is a deductible, and that the out-of-pocket cost for the dose of GARDASIL is part of this deductible, then this amount is eligible for the rebate. The rebate is limited to the amount the private health insurance company indicates on the EOB that the patient or the person responsible for the out-of-pocket cost is obligated to pay for the dose minus $30, up to a maximum of $130. The maximum rebate for each dose is $130, regardless of the amount the patient or the person responsible for the out-of-pocket cost for the dose actually paid or is obligated to pay. All other 2011 Terms and Conditions must still be met.
Back to topThe Explanation of Benefits document, often called an EOB, is sent by the private health insurance company after you receive [your son/daughter receives] medical care. When you receive the EOB for the day that the dose of GARDASIL was administered, it should provide certain details, such as the negotiated contract rate for GARDASIL as well as the out-of-pocket cost you owe for the dose.
Back to topThe length of time a person has to wait for an Explanation of Benefits (EOB) varies by private health insurance company.
Many private health insurance companies mail the EOB; others provide them online. If your private health insurance company does not provide an EOB unless you request it, or does not provide it within 120 days of the date of the medical service, you will need to contact the company to receive one. You may also contact your health care provider to obtain a copy of the EOB your private health insurance company sent him/her since the health care provider's EOB for the dose of GARDASIL administered can also be mailed in to the Patient Rebate Program for GARDASIL under the 2011 Terms and Conditions for the new program in 2011 for doses administered to eligible patients in 2011.
For example, if your private health insurance company provides the EOB quarterly, you may need to contact either your health care provider (to obtain a copy of their EOB) or your private health insurance company to receive the EOB sooner so that you can send in the rebate request form within 120 days of the date of administration of the dose of GARDASIL.
A copy of either the patient's or health care provider's EOB must accompany the original completed rebate request form to be eligible for the rebate. As a reminder, rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate. Please note: Health care provider EOBs are not accepted for doses administered in 2010.
Back to topA copy of either the patient's or health care provider's Explanation of Benefits (EOB) must accompany the original completed rebate request form to be eligible for the rebate. The EOB document is needed to review the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company, to determine the amount of the rebate.
If your private health insurance company did not provide an EOB, you will need to contact the company to receive one. You may also contact your health care provider to obtain a copy of the EOB that was mailed to them by your private health insurance company and use this copy for submission.
As a reminder, rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topA copy of either the patient's or health care provider's Explanation of Benefits (EOB) must accompany the original completed rebate request form to be eligible for the rebate. The EOB document is needed to review the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company, to determine the amount of the rebate.
A bill from your doctor or health care professional is not a valid form of proof of the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company.
If your private health insurance company did not provide an EOB, you will need to contact the company to receive one. You may also contact your health care provider to obtain a copy of the EOB that was mailed to them by your private health insurance company and use this copy for submission.
As a reminder, rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topPhotocopies of either the patient's or health care provider's Explanation of Benefits (EOB) are accepted.
However, photocopies of the rebate request form are not accepted.
Back to topThe Explanation of Benefits (EOB) that is submitted with the rebate request form should contain only the patient's own health information. It is acceptable to black out any additional patient information on the EOB that is not associated with the cost of the dose of GARDASIL.
All patient information contained in the EOB, whether associated with the administration of the dose of GARDASIL or not, will be held in strict confidence by Merck and the third-party administrator.
Back to topIn order to be eligible for a rebate, the out-of-pocket cost for the dose of GARDASIL must be greater than $30.
An out-of-pocket cost equal to or less than $30 is not eligible for a rebate.
The rebate is limited to the amount the private health insurance company indicates on the Explanation of Benefits (EOB) that the patient or the person responsible for the out-of-pocket cost is obligated to pay for the dose of GARDASIL minus $30, up to a maximum of $130. The maximum rebate for each dose is $130, regardless of the amount the patient or the person responsible for the out-of-pocket cost for the dose actually paid or is obligated to pay.
Back to topThe rebate is valid for the out-of-pocket cost for the dose of GARDASIL only. The rebate is not valid for any other products or other out-of-pocket costs (for example, office visit charges, office visit co-payments, or vaccine administration charges) even if such costs are associated with the administration of the dose of GARDASIL.
If it appears that the cost of the dose of GARDASIL reflected on the Explanation of Benefits (EOB) has been bundled with the administration cost, the third-party administrator may initiate contact with the private health insurance company in an attempt to determine the out-of-pocket cost of the dose only.
The rebate is limited to the amount the private health insurance company indicates on either the patient's or health care provider's EOB that the patient or the person responsible for the out-of-pocket cost is obligated to pay for the dose of GARDASIL minus $30, up to a maximum of $130. The maximum rebate for each dose of is $130, regardless of the amount the patient or the person responsible for the out-of-pocket cost for the dose actually paid or is obligated to pay.
Back to topThe private health insurance company determines the format of the Explanation of Benefits (EOB). You will want to be certain that the date of service for the patient listed on either the patient's or health care provider's EOB matches the date of administration of the dose of GARDASIL in the "Health Care Professional Certification" section of the rebate request form and that the EOB document contains a charge for the dose.
If you are uncertain if you have the right document, please contact your health insurance company to confirm that the EOB document is the correct document to be included with the rebate request form.
Back to topIf other medical services were provided the day the dose of GARDASIL was administered to the patient, the patient's Explanation of Benefits (EOB) could contain information that is not associated with the cost of the dose.
Because we need only the information associated with the cost of the dose of GARDASIL to process the rebate, it is acceptable to black out any additional information on the patient's EOB that is associated with other medical services.
All patient information contained in either the patient's or health care provider's EOB, whether associated with the administration of the dose of GARDASIL or not, will be held in strict confidence by Merck and the third-party administrator.
Back to topA copy of either the patient's or health care provider's Explanation of Benefits (EOB) must accompany the original completed rebate request form to be eligible for the rebate. The EOB document is needed to review the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company, to determine the amount of the rebate.
A bill from your [son's/daughter's] pharmacy is not a valid form of proof of the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company.
If your [son's/daughter's] doctor or health care professional did not file a claim with your [his/her] private health insurance company on your [his/her] behalf, you [he/she] will need to contact the private health insurance company to file the claim in order to obtain an EOB.
As a reminder, rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topA copy of the patient's Explanation of Benefits (EOB) must accompany the original completed rebate request form to be eligible for the rebate. The patient's EOB is needed to review the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company, to determine the amount of the rebate.
A receipt from your [son/daughter's] doctor or health care professional is not a valid form of proof of the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company.
If your [son/daughter's] doctor or heath care professional did not file a claim with your [his/her] private health insurance company, you [he/she] will need to contact the company to file the claim in order to obtain an EOB.
As a reminder, Rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topA copy of either the patient's or health care provider's Explanation of Benefits (EOB) must accompany the original completed rebate request form to be eligible for the rebate. The EOB document is needed to review the out-of-pocket cost for the dose of GARDASIL, as set by the private health insurance company, to determine the amount of the rebate.
Whether you are [your son/daughter is] eligible for the rebate will depend on the reason the claim is denied and whether all other 2011 Terms and Conditions of the Program are met. If the EOB submitted indicates that you have [he/she has] private health insurance and you are [he/she is] responsible for the out-of-pocket cost for the dose of GARDASIL in an amount great than $30, and all other 2011 Terms and Conditions are met, you [he/she] would be eligible for the rebate.
An out-of-pocket cost equal to or less than $30 is not eligible for a rebate.
The rebate is limited to the amount the private health insurance company indicates on the Explanation of Benefits (EOB) that the patient or the person responsible for the out-of-pocket cost is obligated to pay for the dose of GARDASIL minus $30, up to a maximum of $130. The maximum rebate for each dose is $130, regardless of the amount the patient or the person responsible for the out-of-pocket cost for the dose actually paid or is obligated to pay.
Back to topYes, as long as the licensed doctor or health care professional who administered the dose of GARDASIL signed the "Health Care Professional Certification" section of the rebate request form with an original signature (stamped signatures are not accepted) and the date of administration of the dose on either the patient's or health care provider's Explanation of Benefits (EOB) matches the date of administration on the rebate request form.
Based on how different private health insurance companies contract with doctor's offices, it is possible that the EOB document to be submitted will list a doctor or health care professional different from the one who actually administered the dose of GARDASIL.
Back to topOnce you learn that your doctor has filed the claim for the dose of GARDASIL, you may need to contact your private health insurance company to receive the Explanation of Benefits (EOB) in time to be eligible for the rebate.
The original completed rebate request form and a copy of the EOB you received from your private health insurance company (that indicates the out-of-pocket cost of GARDASIL to be more than $30) must be postmarked within 120 days after the date of administration of the dose of GARDASIL to be eligible for the rebate.
Rebate request forms for the new 2011 Patient Rebate Program for GARDASIL postmarked more than 120 days after the date of administration of the dose of GARDASIL are not eligible for the rebate.
Back to topYes, you are [your son/daughter is] obligated to pay the doctor or health care professional all costs incurred with the administration of the dose of GARDASIL.
The rebate is intended for the person responsible for the out-of-pocket cost for the dose of GARDASIL only. The rebate is not intended for the doctor or health care professional.
Back to topYou are [your son/daughter is] limited to three (3) rebate request submissions (one for each dose of GARDASIL, provided the eligibility criteria and 2011 Terms and Conditions are met for each dose).
Back to topYou can call 1-800-GARDASIL for information on the status of your rebate.
Back to topPlease call 1-800-GARDASIL.
Back to topPlease call 1-800-GARDASIL.
Back to topTelerx is the third-party administrator processing the Patient Rebate Program for GARDASIL. Telerx is a separate wholly owned subsidiary of Merck.
Back to topThe third-party administrator may need to contact your [son/daughter's] doctor or health care professional, private health insurance company, and/or you [your son/daughter] in order to process the rebate.
For example, based on the Explanation of Benefits (EOB) document submitted, it may be unclear what the out-of-pocket cost for the dose of GARDASIL is. The third-party administrator would contact your private health insurance company to help validate this information.
Back to topFor female patients, the Patient Rebate Program for GARDASIL has been available for doses of GARDASIL administered between April 1, 2009, and December 31, 2010. Doses administered before April 1, 2009 are not eligible.
For male patients, the Patient Rebate Program for GARDASIL has been available for doses of GARDASIL administered between January 1, 2010, and December 31, 2010. Doses administered before January 1, 2010, are not eligible. 2010 Terms and Conditions, including a deadline to submit rebate request forms apply.
Beginning on January 1, 2011, the Patient Rebate Program for GARDASIL will remain available to all eligible patients from January 1, 2011, through December 31, 2011, under the new 2011 Terms and Conditions for GARDASIL doses administered during the 2011 calendar year.
Merck reserves the right to rescind, cancel, or amend this offer at any time without notice.
Back to topYour doctor or health care professional can visit gardasilrebate.com or call 1-800-GARDASIL to learn more about the Program Rebate Program.
Back to top
GARDASIL is the only human papillomavirus (HPV) vaccine that helps protect against 4 types of HPV. In girls and young women ages 9 to 26, GARDASIL helps protect against 2 types of HPV that cause over 75% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases. In boys and young men ages 9 to 26, GARDASIL helps protect against 90% of genital warts cases.
GARDASIL may not fully protect everyone, nor will it protect against diseases caused by other HPV types or against diseases not caused by HPV. GARDASIL does not prevent all types of cervical cancer, so it's important for women to continue routine cervical cancer screenings. GARDASIL does not treat cervical cancer or genital warts. GARDASIL is given as 3 injections over 6 months.
Anyone who is allergic to the ingredients of GARDASIL, including those severely allergic to yeast, should not receive the vaccine. GARDASIL is not for women who are pregnant.
The side effects include pain, swelling, itching, bruising, and redness at the injection site, headache, fever, nausea, dizziness, vomiting, and fainting. Fainting can happen after getting GARDASIL. Sometimes people who faint can fall and hurt themselves. For this reason, your health care professional may ask you to sit or lie down for 15 minutes after you get GARDASIL. Some people who faint might shake or become stiff. This may require evaluation or treatment by your health care professional.
Only a doctor or health care professional can decide if GARDASIL is right for you or your child.
Please read the Patient Product Information or the Prescribing Information for GARDASIL.
