Guide. Astellas Pharma US, Inc. XTANDI Access Services SM 2015 NCCN Virtual Reimbursement Resource Room. NCCN.org/reimbursement
|
|
- Wilfred Jefferson
- 8 years ago
- Views:
Transcription
1 Astellas Pharma US, Inc. XTANDI Access Services SM 2015 NCCN Virtual Reimbursement Resource Room Guide The oncology reimbursement landscape continues to present ever-evolving challenges for clinicians and others who work with patients with cancer. As a response to these ongoing challenges, help is available at the NCCN Virtual Reimbursement Resource Room at. Users can search by cancer type or supportive care indication, drug name, or by reimbursement or assistance program to learn about available reimbursement help and services to help mitigate reimbursement challenges. Visit the NCCN Virtual Reimbursement Resource Room today and learn about available reimbursement help and services at: FREE App available on Google Play or Apple Store
2 NCCN Virtual Reimbursement Resource Room Astellas Pharma US, Inc. XTANDI Support Solutions SM Guide Astellas Pharma US, Inc. XTANDI Support Solutions SM 3 Biodesix 5 Boehringer Ingelheim Solutions Plus 5 Bristol-Myers Squibb Access Support 6 BTG International Inc. 6 Celgene Patient Support 7 Eisai Assistance Program (EAP) 7 Genentech Access Solutions 8 IncyteCARES (Incyte Corporation) 8 Lilly PatientOne: Reimbursement & Patient Assistance Program 9 Medivation, Inc. 10 Onyx Pharmaceuticals 10 Patient Access Network (PAN) Foundation 10 Patient Assistance NOW Oncology (PANO) (Novartis Oncology) 11 REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals) 12 Seattle Genetics SeaGen Secure 13 Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise) 13 Xofigo Access Services (XAS) Program 14 ZytigaOne TM Support 15
3 3 Astellas Pharma US, Inc. XTANDI Support Solutions SM Your Patients Your Practice Your Choice XTANDI Support Solutions SM is designed as a single point of contact to help patients and their loved ones understand their coverage and reimbursement options for XTANDI (enzalutamide) capsules. Astellas is firmly committed to ensuring our patients have access to XTANDI, regardless of their financial status. We are here to answer questions about your insurance coverage and options for filling your prescription in order to get you started on therapy as quickly as possible. Flexible and integrated resources for patient access and support: Covers the needs of patients with private insurance and Medicare, as well as uninsured patients Physicians can send a prescription directly to a Specialty Pharmacy Provider in the network, HUB call center, or self-dispense out of an office based pharmacy Provides patient benefit verification and support with prior authorization and appeals assistance XTANDI Patient Savings Program SM Co-pay assistance for privately insured patients One time enrollment per year or 12 monthly refills Patients pay no more than $20.00/month with an annual maximum benefit of up to $12,000/year Quick Start+ for XTANDI To enable rapid initiation of treatment, the Quick Start+ program for XTANDI provides a one-time, 14-day gratis fill supply of XTANDI that requires a physician prescription. Quick Start+ is intended for new patients who have not received a coverage decision from their payer (for example, a benefit verification or prior authorization is pending) in time to start therapy in 10 business days. Quick Start+ offers several benefits: Allow patients to start treatment with XTANDI while XTANDI Support Solutions SM troubleshoots issues Provides quick delivery time so patients can start therapy as soon as possible Offers direct-to-patient shipping Continued on next page
4 4 Astellas Pharma US, Inc. XTANDI Support Solutions SM Continued from previous page Astellas Access Program SM Astellas is committed to supporting and maintaining access to medications for patients who are treated with an Astellas product. The Astellas Access Program SM for XTANDI is designed for patients who have no health insurance. This program provides free XTANDI to patients who qualify for enrollment based on insurance and household income status. Eligibility is determined on a patient-specific basis. XTANDI Support Solutions SM can quickly determine whether a patient is eligible for enrollment. If you need assistance with the Astellas eservice site, XTANDI Support Solutions SM or have any questions on coding, coverage, and reimbursement for Astellas products, please contact us between the hours of 9:00 am and 8:00 pm ET Monday through Friday. Contact Us XTANDI Support Solutions SM Monday Friday, 9:00 am 8:00 pm ET Phone: XTANDI ( ) Fax: Mailing Address: Astellas Access Services SM P. O. Box La Jolla, CA For Full Prescribing Information please see or contact Astellas Medical Communication at XTANDI and Astellas are trademarks of Astellas Pharma Inc. XTANDI Support Solutions SM is a component of Astellas Access Services SM.
5 5 Biodesix VeriStrat is a serum protein test that is predictive of significant differential overall survival treatment benefit between erlotinib and single-agent chemotherapy for patients with advanced NSCLC who are EGFR wild-type or whose EGFR mutation status is unknown. The test is used in patients who have progressed after or are ineligible for platinum-based doublet chemotherapy. For Patients with Medicare: VeriStrat is covered by Medicare for patients with non-small cell lung cancer who are EGFR wild-type or whose mutation status is unknown. For Patients with Private Insurance: Biodesix will file the claim and any necessary appeal with the patient s insurance company. The amount the patient is required to pay for VeriStrat testing depends on their insurance plan. The patient may be responsible for a co-payment, co-insurance, or a deductible. Biodesix Assist Financial Support Program: If the patient has a financial responsibility, the patient s insurance does not cover VeriStrat, or the patient does not have insurance, they may be eligible for the Biodesix Assist Financial Support Program, which may help to reduce or eliminate the cost of the test. If you have any questions at all regarding coverage and payment, please contact the VeriStrat Support Hotline at Boehringer Ingelheim Solutions Plus Making patient support our priority by providing a broad range of access, reimbursement and clinical support solutions for patients who are prescribed GILOTRIF (afatinib) tablets. Our goal is to help patients quickly and affordably access GILOTRIF Additionally, we provide patient education, adverse event and dose management support to complement care Improving the overall patient support experience Single, dedicated specialty pharmacy, Accredo Single point of contact Efficient, reliable service Consistent patient support Innovative programs to support treatment Call Solutions Plus at from 8 am to 8 pm EST or online at
6 6 Bristol-Myers Squibb Access Support Bristol-Myers Squibb Oncology is committed to helping appropriate patients get access to our medications by providing reimbursement support services for healthcare professionals. Bristol-Myers Squibb Oncology: Access Support is a comprehensive resource for Reimbursement Support Services and Patient Assistance that offers access services for patients including: Benefit Investigation Appeals Assistance Alternative coverage search Prior Authorization Assistance Patient Assistance To learn more about BMS Access Support, please visit our web site or call the toll-free number to speak with a reimbursement counselor. Phone: Monday Friday, 8:00 am to 8:00 pm ET BTG International Inc. BTG is a specialist healthcare company focused on three business areas: Interventional Medicine, Specialty Pharmaceuticals and Licensing. BTG s Interventional Medicines include Interventional Oncology products used to treat patients with liver tumors and Interventional Vascular products used to treat patients with severe blood clots and patients with varicose veins in the great saphenous vein system of the leg. BTG s Specialty Pharmaceutical products include antidotes to treat snake envenomation and toxicity associated with medicines used for heart conditions and cancer. Company and product website addresses:
7 7 Celgene Patient Support Celgene Patient Support provides a dedicated, central point of contact for patients and healthcare professionals who use Celgene products. Celgene Patient Support is a free service that helps patients and healthcare professionals navigate the challenges of reimbursement, providing information about co-pay assistance, and answering questions about obtaining Celgene products. Facilitate prior authorization Assist with appeal support after insurance denials Navigate your Medicare coverage Assess co-pay options Follow up on your prescription status Help you apply for the Celgene free medication program Guide you through Celgene products and restricted distribution programs or Eisai Assistance Program (EAP) Eisai s commitment to innovative solutions in disease prevention, treatment and care for the health and well-being of people worldwide is embodied in our human health care (hhc) mission: we give first thoughts to patients and their families by helping to ensure access to necessary medicines. With this in mind, the Eisai Assistance Program (EAP) provides dedicated reimbursement and access support for patients and healthcare professionals to reduce barriers to patient access to medicines. Specifically, EAP offers the following services: insurance verification prior authorization information appeal information alternate coverage/funding information Patient Assistance Program (PAP) enrollment expediting product access and minimizing barriers to access To learn more about the Eisai Assistance Program, please visit our website or call our toll-free number EISAI.4.U ( ) or
8 8 Genentech Access Solutions We Focus on Access So You Can Focus on Health If you are concerned about paying for your Genentech medicine, we are here to help. Whether you have health care coverage or not, we can help you by: Finding out if your health care plan pays for your medicine Guiding you through the process of getting your medicine Connecting you with our patient assistance programs Visit to learn more about these programs and how to get started. To speak live with one of our Specialists, call (866) 4ACCESS/(866) IncyteCARES (Incyte Corporation) IncyteCARES (Connecting to Access, Reimbursement, Education and Support) was established by Incyte to assist providers, patients, and caregivers through a single point of contact with reimbursement assistance, patient access, and distribution coordination for Jakafi (ruxolitinib). IncyteCARES assists healthcare professionals and eligible patients with product access through a suite of services, including: Benefit verification, prior authorization and appeals assistance, and Jakafi delivery coordination Co-pay assistance for privately insured patients who meet the program s eligibility requirements Access to Jakafi free of charge for patients who do not have insurance and meet the program s eligibility requirements Referral to independent and nonprofit organizations that may be able to provide financial assistance Patient education and support You can contact IncyteCARES, between 8:00 am 8:00 pm, by calling: JAKAFI ( ) or visit for more information.
9 9 Lilly PatientOne: Reimbursement & Patient Assistance Programs The Lilly PatientOne program is committed to helping eligible patients access support programs for Lilly Oncology products they are prescribed. It aims to address both financial and coverage issues for qualified uninsured, underinsured, and insured patients who are prescribed a Lilly Oncology product. PatientOne strives to offer resources, ranging from benefits investigations to financial assistance and appeals information, that provide reliable and individualized treatment support for eligible patients. Services offered by this program include: Insurance Expertise Coding and billing information Payment methodologies and allowables Payer policy information Patient Assistance Program Drug replacement for eligible patients Financial Assistance Information about co-pay assistance foundations Co-pay program to assist eligible patients with out-of-pocket costs for specific Lilly Oncology products where available Reimbursement Assistance for Eligible Lilly Oncology Products for an Approved Diagnosis Eligibility determination Benefits investigation Prior authorization Evaluation of other fund options Denied Claim Appeals Appeals status if requested Denied claims appeals templates, forms, and checklists For more information call 866.4PatOne ( ) Monday Friday, 9:00 am 7:00 pm EST or visit
10 10 Medivation, Astellas Pharma Inc. US, Inc. XTANDI Support Solutions SM To learn about this program, visit Text Onyx Pharmaceuticals Onyx 360 sets a new standard of personalized treatment support for patients, caregivers, and practices. You and your patients will have access to a dedicated Oncology Nurse Advocate and a wide range of services and support, including: Reimbursement Assistance Co-pay/Co-insurance assistance Free product assistance for eligible patients Clinical Support Information about the disease Side effect management Referrals to Third-party Organizations for Day-to-Day and Emotional Support Assistance with transportation to scheduled appointments Patient and caregiver counseling services Support group information Talk to Your Patients About Onyx 360 Today. To learn more about these services, please call ONYX.360 ( ). Patient Access Network (PAN) Foundation ( ) The Patient Access Network (PAN) Foundation provides help and hope to underinsured patients with chronic or life-threatening illnesses to more than 50 disease-specific co-payment assistance programs. Since 2004, PAN has provided over $700 million in financial assistance to more than 300,000 patients who would otherwise be unable to afford their mediations. PAN makes it simple for patients and providers to obtain the financial assistance they need quickly through a streamlined application process and online portals.
11 11 Patient Assistance NOW Oncology (PANO) (Novartis Oncology) Helping to make access to the therapies you need easier Novartis Oncology is committed to helping patients living with cancer receive the medicines they need. Patient Assistance NOW Oncology offers quick and easy access to information about the broad array of support and reimbursement programs available. You can get information about our Patient Assistance NOW Oncology support programs in 2 ways: Call to speak with a member of our knowledgeable staff dedicated to making access to our programs as simple and convenient as possible; or Visit our website at: Support for patients includes: Insurance verification Coding/billing questions Medicare education Therapy-specific support programs for out-of-pocket costs Alternative assistance searches and referrals to federal or state assistance programs Referrals to independent charitable foundations for assistance with co-pay costs Assistance with denials/appeals Patient assistance for low-income and uninsured patients Patients prequalifed via phone screening for the Patient Assistance Program (PAP) will be sent a 30-day supply of their needed medication while completing the application Convenient provider portal to access program services or check the status of patients enrolled
12 12 REACH (Resource for Expert Assistance and Care Helpline) (Bayer HealthCare Pharmaceuticals) The REACH program assists patients with their coverage options for Nexavar (sorafenib) tablets and Stivarga (regorafenib) tablets. Nexavar and Stivarga are distributed through designated specialty pharmacy providers (SPPs); it is not available through retail pharmacies. A REACH program counselor will work with Payers and patients to identify an SPP that will fill the Nexavar or Stivarga prescription and send it directly to the patient s home. A REACH program counselor will also call patients to provide help in understanding insurance coverage and the Medicare Part D drug benefit and aid in finding other sources of payment for Nexavar or Stivarga. Enrollment forms are available via REACH at ( ), Monday through Friday from 9:00 am to 8:00 pm EST, or at or The Reimbursement Support Line team has experience with all payer types, including Medicare. Questions answered by the team typically can be classified into one of the following groups: Benefit verification Coding information and billing instruction Claims review Claims-appeal assistance Prior-authorization assistance Patient assistance The On-call Team closely monitors the reimbursement environment for latest changes in Medicare, Medicaid, and private payer reimbursement and coverage polices. In addition, Bayer HealthCare Pharmaceuticals offers a patient assistance program that provides assistance to uninsured patients who meet the program requirements.
13 13 Seattle Genetics SeaGen Secure SeaGen Secure TM is a comprehensive assistance program for patients who have been prescribed ADCETRIS TM (brentuximab vedotin) and for the healthcare providers caring for them. Services offered by the program include: Patient Assistance and Reimbursement Support Benefits Verification Prior Authorization Assistance Co-insurance Assistance Claims Tracking Appeal Assistance and Tracking Billing and Coding Support General Payer and Policy Research Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise) Teva Oncology: CORE (Comprehensive Oncology Reimbursement Expertise) offers reimbursement support for branded Teva Oncology products. Some of the options include benefit verification, prior authorization support and customer service through the claims and appeals process. CORE also provides referrals to the Teva Cares patient assistance program. For more information or an introductory consult please call or visit
14 14 Xofigo Access Services (XAS) Program Xofigo Access Services (XAS) Program is a single point of contact to process all Xofigo (radium Ra 223 dichloride injection) orders distributed through a single designated Specialty Pharmacy Provider. XAS is a platform to provide all market access support (e.g. PAP, copay assistance, BV) for referring and treating providers, an integrated solution for order management with Cardinal Health, and data collection point to track and maintain information collected from performed provider services. A Xofigo Access Services counselor will work with the provider to help patients in understanding their individual insurance coverage and aid in finding the best support options for Xofigo. Xofigo Access Services Intake forms, Patient Assistance forms, & Benefit Verification request forms are available at or via phone ( Xofigo) ( ) Monday through Friday 9:00 am 8:00 pm EST. The Xofigo Access Services Support includes: Product Order and Patient Scheduling Confirmation Product Order request processing Appointment and treatment schedule confirmation Seamless transfer for administrating provider to Cardinal Health Questions regarding returns, damaged product, patient cancellations, or rescheduling Reimbursement Support Insurance benefit verifications Prior authorization support Claims appeal research and information Claims tracking Billing and coding information Payer policy information Patient Assistance Program Assistance for qualified uninsured and underinsured patients who meet specific criteria Copay Assistance Program Copay assistance for qualified commercially insured patients Copay assistance triage to foundations for other insured patients
15 15 ZytigaOne Support Janssen Biotech, Inc., the manufacturer of ZYTIGA (abiraterone acetate), has developed ZytigaOne Support to help make access to ZYTIGA simple, convenient, and easy. ZytigaOne Support provides focused attention and personalized support to help you and your patients with access to ZYTIGA. Support For You Rapid investigation and assessment of patient eligibility and coverage Assistance with the prior authorization and appeal process, plus concise benefit summary to physicians and staff Information on cost support options, including updates on independent foundation funding status Electronic enrollment through an online portal Identification of a Specialty Pharmacy Provider (SPP) Access to medication order information A personally-assigned Site Coordinator Support For Your Patients Explanation of benefits from a personally-assigned Care Coordinator Referral to cost support options, including the ZytigaOne Instant Savings Program for eligible patients Upon request, follow-up status calls to those referred for cost support Coordination with SPP for processing and delivery of medication Educational materials and personalized prescription reminders, if requested Visit for more information about how to enroll patients in ZytigaOne Support or call your personally assigned ZytigaOne Support Site Coordinator today. Contact ZytigaOne Support ZYTIGA-1 ( ) Monday Friday, 8:00 am 8:00 pm ET Before prescribing ZYTIGA (abiraterone acetate), please see full Prescribing Information including Dosage and Administration, Warnings and Precautions available at
16 16 NCCN Reimbursement Resource App The cost of cancer care continues to rise and patients with cancer and their caregivers often struggle to pay for therapy. As a response to these ongoing challenges, help is available through the NCCN Reimbursement Resource App; users are able to search for available resources and payment assistance programs. Search by: Cancer Type or Supportive Care Indication Drug Name Reimbursement or Assistance Program Download for Free! The NCCN Reimbursement Resource App for Patients, Caregivers, and Health Care Professionals Now available for Apple and Android smartphones and tablets! Visit the App Store SM Search NCCN Apple is a trademark of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. Google Play is a trademark of Google Inc. Android is a registered trademark of Google. Visit the Google Play Store Search NCCN Technical development supported by ARIAD Pharmaceuticals, Inc.; Genentech, a Member of the Roche Group; and Teva Oncology. Now available for smartphones and tablets! 275 Commerce Drive Suite 300 Fort Washington, PA NCCN.org For Physicians NCCN.org/patients For Patients NCCN.org-N
Northwest Georgia Oncology Centers, P.C.
Northwest Georgia Oncology Centers, P.C. High Deductibles and Out of Pocket HSA/HRA Plans (No up front collection) Medicare Advantage Plans Healthcare Exchange Plans Medicare only Cobra plans/high premiums
More informationComplete the enrollment form on the reverse side to join Onyx 360 today.
Complete the enrollment form on the reverse side to join Onyx 360 today. Oncology Nurse Advocates are available Monday through Friday, from 9 am to 8 pm Eastern Standard Time at 1-855-ONYX-360 (1-855-669-9360)
More informationNOVARTIS SERVICE REQUEST FORM FOR PATIENT SUPPORT
NOVARTIS SERVICE REQUEST FORM FOR PATIENT SUPPORT Please complete the Fax Cover Sheet and Service Request Form, and fax all pages to the number specified below. Dear Health Care Professional: The Novartis
More informationBristol-Myers Squibb Access Support Program. What Medications does the BMS Access Support Program help with? Program Registration Steps
Oncology Reimbursement Support Phone: 1-800-861-0048 Fax: 1-888-776-2370 Bristol-Myers Squibb Access Support Program The Bristol-Myers Squibb Access Support Program is designed to help patients with reimbursement
More informationNovel Opportunities for Engagement Utilizing in House Pharmacy Services
Novel Opportunities for Engagement Utilizing in House Pharmacy Services Ray Bailey, BSPharm RPh Director of Pharmacy, FCS Rx to Go Pharmacy rbailey@flcancer.com Angel Aslo, Pharm.D. Director of Pharmacy,
More informationThese are just some of the eligibility requirements meeting these criteria does not guarantee acceptance.
BARACLUDE PATIENT ASSISTANCE PROGRAM The Baraclude Patient Assistance Program is designed to provide free medication to qualifying patients who do not have prescription drug coverage and are having a hard
More informationPATIENT SUPPORT, PATIENT ADVOCACY, AND REIMBURSEMENT SERVICES
PATIENT SUPPORT, PATIENT ADVOCACY, AND REIMBURSEMENT SERVICES SANOFI-AVENTIS ONCOLOGY PATIENT SUPPORT, PATIENT ADVOCACY, AND REIMBURSEMENT SERVICES Sanofi-aventis is dedicated to providing access to oncology
More informationA PATIENT S GUIDE Understanding Your Healthcare Benefits
A PATIENT S GUIDE Understanding Your Healthcare Benefits This guide includes useful information about how health insurance works and the reimbursement process used to pay for treatments. TABLE OF CONTENTS
More informationNOVARTIS SERVICE REQUEST FORM FOR PATIENT SUPPORT
NOVARTIS SERVICE REQUEST FORM FOR PATIENT SUPPORT Please complete the Fax Cover Sheet and Service Request Form, and fax all pages to the number specified below. Dear Health Care Professional: The Novartis
More information10/4/10. Risë Marie Cleland Rise@Oplinc.com
Risë Marie Cleland Rise@Oplinc.com describe trends increasing the financial risk for practices & patients, understand how financial counseling minimizes this risk identify key tasks & Best Practices in
More informationSUPPORT PATH PROGRAM INTAKE FORM PHONE: 1-855-769-7284 FAX: 1-855-298-8700
SUPPORT PATH PROGRAM INTAKE FORM PHONE: 1-855-769-7284 FAX: 1-855-298-8700 1 REQUESTED SERVICE(S) (REQUIRED) CHECK ALL BOXES THAT APPLY Benefits Investigation Prior Authorization and Appeals Support Patient
More informationContents General Information... 1. General Information
Contents General Information... 1 Preferred Drug List... 2 Pharmacies... 3 Prescriptions... 4 Generic and Preferred Drugs... 5 Express Scripts Website and Mobile App... 5 Specialty Medicines... 5 Prior
More informationI Have Health Insurance! Now What?
I Have Health Insurance! Now What? A Guide to Using Your Private Health Insurance Plan Brought to you by: Congratulations on Your New Health Plan! This guide is an overview of private insurance plans and
More informationThe Evolving Landscape of Payment Care Delivery and Manufacturer Implications of Coverage Expansion
November 2013 Edition Vol. 7, Issue 10 The Evolving Landscape of Payment Care Delivery and Manufacturer Implications of Coverage Expansion By Gordon Gochenauer, Director, Oncology Commercial Strategies,
More informationRemove Access Barriers and Maximize Product Uptake with an Integrated Hub Model Approach
Remove Access Barriers and Maximize Product Uptake with an Integrated Hub Model Approach When it comes to supporting the clinical and marketing objectives of any pharmaceutical franchise, helping to remove
More informationA Guide to Patient Services. Cedars-Sinai Health Associates
A Guide to Patient Services Cedars-Sinai Health Associates Welcome Welcome to Cedars-Sinai Health Associates. We appreciate the trust you have placed in us by joining our dedicated network of independent-practice
More informationI Have Health Insurance! Now What?
I Have Health Insurance! Now What? A Guide to Using Your Private Health Insurance Plan Brought to you by: Congratulations on Your New Health Plan! This guide is an overview of private insurance plans and
More informationGLEEVEC PATIENT ASSISTANCE PROGRAM USA Patient Guide. Joan D. Ramos, MSW Cancer Resources & Advocacy Seattle, WA
GLEEVEC PATIENT ASSISTANCE PROGRAM USA Patient Guide Joan D. Ramos, MSW Cancer Resources & Advocacy Seattle, WA This guide is for informational purposes only and does not constitute legal or medical advice.
More informationReimbursement Guide 2011
Reimbursement Guide 2011 IMPORTANT SAFETY INFORMATION HYALGAN is indicated for the treatment of pain in osteoarthritis (OA) of the knee in patients who have failed to respond adequately to conservative
More informationFREQUENTLY ASKED QUESTIONS ABOUT THE CVS CAREMARK PRESCRIPTION DRUG PROGRAM
FREQUENTLY ASKED QUESTIONS ABOUT THE CVS CAREMARK PRESCRIPTION DRUG PROGRAM ABBVIE EMPLOYEES WANT TO KNOW What s New in 2015? AbbVie is making changes in its pharmacy benefit program to ensure our medical
More informationFINANCIAL ASSISTANCE RESOURCES
FINANCIAL ASSISTANCE RESOURCES TREATMENT ASSISTANCE CancerCare, 800-813-4673 http://www.cancercare.org/get_help/assistance/cc_financial.php CancerCare is a national nonprofit agency that offers free support,
More informationGENERAL INFORMATION. With Express Scripts, you have access to:
CONTENTS GENERAL INFORMATION... 1 PREFERRED DRUG LIST....2 PHARMACIES... 3 PRESCRIPTIONS... 4 GENERIC AND PREFERRED DRUGS... 5 EXPRESS SCRIPTS WEBSITE AND MOBILE APP... 5 SPECIALTY MEDICATIONS... 6 PRIOR
More informationPharmacy Handbook. Understanding Your Prescription Benefit
Pharmacy Handbook Understanding Your Prescription Benefit 1 Welcome to Your Prescription Drug Plan! Health Republic Insurance of New York has partnered with US Script to manage your prescription drug benefits.
More informationA Co-Payment Assistance Program for Insured Patients
A Co-Payment Assistance Program for Insured Patients Providing Critical Financial Support for Patients Access Financial Assistance Simply and Efficiently Patient Advocate Foundation s (PAF) Co-Pay Relief
More informationYou have from October 15 until December 7 to make changes to your Medicare coverage for next year.
Advantra Gold (HMO) offered by HealthAmerica Pennsylvania, Inc. Annual Notice of Changes for You are currently enrolled as a member of Advantra Gold (HMO). Next year, there will be some changes to the
More informationInsurance and Reimbursement Resources for MDS Patients
Insurance and Reimbursement Resources for MDS Patients A Guide to Assistance Programs in the United States Third Edition the myelodysplastic syndromes foundation, inc. Published by The Myelodysplastic
More informationHow to Request an Exception or Appeal a Decision From Your Prescription Drug Plan
How to Request an Exception or Appeal a Decision From Your Prescription Drug Plan Exceptions What is an Exception? Sometimes you may not be able to obtain a prescription medication that your healthcare
More information2014 Southcoast Health Plan Frequently Asked Questions
2014 Southcoast Health Plan Frequently Asked Questions What does Southcoast Health Plan offer me? Southcoast Health Plan provides members with broad access to quality health care at an affordable price.
More informationUnderstanding Your Health Insurance Plan
Understanding Your Health Insurance Plan Slide Catalog for Assisters Updated May 6, 2015 Health Insurance Costs Terms to Know: Premium Premium: The monthly bill you pay to your health insurance company.
More informationStonebridge Adult Medicine, P.A. Registration Form (Please Print)
Stonebridge Adult Medicine, P.A. Registration Form (Please Print) PATIENT INFORMATION Last Name: First Name: Is this your legal name? Yes No If not what is your legal name: Date of Birth: Sex: male female
More informationpatient ONE FOCUS: CANCER ONE WORLD-CLASS TEAM DEDICATED TO YOUR CARE Choosing the Right Insurance Plan Before You Need It THE ROSWELL PARK ADVANTAGE
patient ELM & CARLTON STREETS BUFFALO, NEW YORK 14263 1-877-ASK-RPCI (1-877-275-7724) www.roswellpark.org THE ROSWELL PARK ADVANTAGE No one expects to get cancer, but if you or a loved one should need
More informationUnitedHealthcare Injectable Chemotherapy Prior Authorization (PA) Program Frequently Asked Questions
UnitedHealthcare Injectable Chemotherapy Prior Authorization (PA) Program Frequently Asked Questions Q1. What members are impacted by the UnitedHealthcare Injectable Chemotherapy PA Program? A. Beginning
More informationAnnual Notice of Changes for 2014
First Health Part D Premier Plus (PDP) offered by Cambridge Life Insurance Company Annual Notice of Changes for 2014 Dear Member, You are currently enrolled as a member of First Health Part D Premier Plus
More informationDrug Coverage Programs for Patients with Cancer
Drug Coverage Programs for Patients with Cancer UHN Information for patients and families Read this guide to learn about: different drug coverage programs which program to use and how to use it who to
More informationAnnual Notice of Changes for 2014
Blue Medicare HMO SM Standard offered by Blue Cross and Blue Shield of North Carolina (BCBSNC) Annual Notice of Changes for 2014 You are currently enrolled as a member of Blue Medicare HMO Standard. Next
More informationTransitioning to Express Scripts
Transitioning to Express Scripts Welcome to Express Scripts. We re pleased to announce that, beginning 1/1/2015 the City of Frisco prescription benefit will be managed by Express Scripts. Express Scripts
More informationMAWD or Marketplace?
MAWD or Marketplace? What Pennsylvanians with Disabilities Need to Know About Choosing Health Insurance Coverage Summary Choosing health insurance coverage that best meets one s needs is important, especially
More informationAnnual Notice of Changes for 2014
Advocare Spirit Rx (HMO-POS) offered by Security Health Plan of Wisconsin, Inc. Annual Notice of Changes for 2014 You are currently enrolled as a member of Advocare Spirit Rx (HMO-POS). Next year there
More informationSpecialty Pharmacy Definition
Isn t All of Special? Developing Services Presented to: 2015 ICHP Annual Meeting Presented on: September 10, 2015 Presented by: Lana Gerzenshtein, Pharm.D., BCPS The speaker has no conflicts of interest
More informationAnnual Notice of Changes for 2015
First Health Part D Value Plus (PDP) Plan offered by First Health Life & Health Insurance Company Annual Notice of Changes for 2015 You are currently enrolled as a member of First Health Part D Essentials
More informationANNUAL NOTICE OF CHANGES FOR 2016
Cigna-HealthSpring Preferred Plus (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred Plus (HMO). Next year, there
More informationLILETTA Patient Savings Program
LILETTA Patient Savings Program Information and materials for your office and LILETTA patients Set up your office today by calling 855-706-4508 LILETTA Patient Savings Program Overview With the LILETTA
More informationPatient Tools: What You Need to Know about Paying for Your Osteoporosis Medications. February 2012. Developed by the National Osteoporosis Foundation
Patient Tools: about Paying for Your Osteoporosis Medications Developed by the National Osteoporosis Foundation February 2012 Paying for Your Osteoporosis Medications: What You Need to Know How much your
More informationMultiple sclerosis and health insurance: How to choose a plan that is right for you
Multiple sclerosis and health insurance: How to choose a plan that is right for you What are the different types of health insurance? Choosing a health insurance plan is important, especially if you have
More informationWelcome to OptumRx Your Prescription Benefit Program
Welcome to OptumRx Your Prescription Benefit Program OptumRx offers you more ways to improve your health, while keeping medications more affordable and accessible. Welcome to OptumRx OptumRx manages your
More information4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21. Welcome to Avera Health Plans
Member Guide 1 1 Welcome to Avera Health Plans 2 In Your Neighborhood Benefits of Health Insurance Understanding Health Insurance Terms 3 Get on Track With Your Insurance Coverage 4-5 Member Resources
More informationSummary of Benefits. (PDP), Blue MedicareRx Plus SM. (PDP) and Blue MedicareRx Premier SM
Summary of Benefits for SM, Plus SM and Premier SM Available in Maine and New Hampshire A -approved Part D sponsor. Anthem Insurance Companies, Inc. (AICI) is the legal entity who has contracted with the
More informationSaving Money on Prescription Drugs
Reference Guide to Saving Money on Prescriptions Revised: July 11, 2006 Prescription medications can be a heavy financial burden for individuals and families. Many people feel limited to receiving assistance
More informationOFFICE POLICIES, EFFECTIVE October 19, 2009
Thank you for choosing our office for your medical care. We have written these policies to keep you informed of our current office policies. Please refer to our website for policy updates. OFFICE POLICIES,
More informationZimmer Payer Coverage Approval Process Guide
Zimmer Payer Coverage Approval Process Guide Market Access You ve Got Questions. We ve Got Answers. INSURANCE VERIFICATION PROCESS ELIGIBILITY AND BENEFITS VERIFICATION Understanding and verifying a patient
More informationReminder: ProviderAccess users no longer receiving paper remittances starting September 1, 2009
AUGUST 7, 2009 NEVADA Exclusive DME Contract with Bennett Medical Services As a reminder, Anthem Blue Cross and Blue Shield and our subsidiary company, HMO Nevada, have an exclusive agreement with Bennett
More informationFinancial Planning. Patient Education Guide to Your Kidney/Pancreas Transplant Page 18-1. For a kidney/pancreas transplant.
Patient Education Page 18-1 For a kidney/pancreas transplant Kidney and pancreas transplants are expensive. Planning your finances, both your income and insurance, will be a key part of planning for transplant.
More informationFirst Health Part D Value Plus (PDP) offered by First Health Life & Health Insurance Company
First Health Part D Value Plus (PDP) offered by First Health Life & Health Insurance Company Annual Notice of Changes for 2016 You are currently enrolled as a member of First Health Part D Value Plus (PDP).
More informationSIMPLICITY. 2015 Your Plan Explained
Hello SIMPLICITY 2015 Your Plan Explained PFIZER UnitedHealthcare Group Medicare Advantage (PPO) Effective January 1, 2015, through December 31, 2015 Group Number: 12367, 12368 Benefit Highlights UnitedHealthcare
More informationUsing Your Medicare Drug Plan: What to Do if Your Medicine Isn t Covered
Using Your Medicare Drug Plan: What to Do if Your Medicine Isn t Covered SPRING 2009 9 www.yourpharmacybenefit.org Table of Contents How does it work?............................................ 1 When
More informationWelcome to the LILETTA Patient Savings Program
Welcome to the LILETTA Patient Savings Program Eligible insured patients, activate your card today* * See full program Terms and Conditions on page 3 of this brochure or at LILETTAcard.com. Help With Your
More informationNew York City Office of Labor Relations Employee Benefits Program/Municipal Labor Committee
New York City Office of Labor Relations Employee Benefits Program/Municipal Labor Committee PICA PRESCRIPTION DRUG PROGRAM Self-Injectable Medications Chemotherapy Medications Questions & Answers Last
More informationMedication Assistance Programs
St. Louis Chapter 24/7 Helpline: (800) 272-3900 www.alzstl.org serving 38 counties in Eastern MO and Western IL Please Note: It is important that your loved one receive quality care. The information is
More informationMedicare. What you need to know. Choose the plan that s right for you GNHH2ZTHH_15
Medicare What you need to know Choose the plan that s right for you GNHH2ZTHH_15 Choosing a Medicare plan is a lot like buying a car. There are lots of options to consider. And what s right for you may
More informationExceptions and Appeals for Drug Therapies: A Guide for Healthcare Providers
Exceptions and Appeals for Drug Therapies: A Guide for Healthcare Providers Table of Contents Introduction... 5 Prior Authorization... 7 Overview... 7 Step Therapy... 7 Quantity Limits... 7 The Prior Authorization
More informationAnnual Notice of Changes for 2014
ConnectiCare VIP Employer Group (HMO-POS) offered by ConnectiCare, Inc. Connecticut Business & Industry Association (CBIA) Annual Notice of Changes for 2014 You are currently enrolled as a member of ConnectiCare
More informationMedicare doesn t have to be complicated. This guide is provided to help you better understand Medicare and how a Medicare Advantage plan may offer
clarity YOUR GUIDE TO MEDicare AdvantaGE Medicare doesn t have to be complicated. This guide is provided to help you better understand Medicare and how a Medicare Advantage plan may offer the coverage
More informationPatient Financial Policy
Patient Financial Policy We want you to concentrate on feeling better instead of worrying about how you're going to pay your bill. Please review this Patient Financial Policy for answers to commonly asked
More informationUnderstanding Prescription Assistance Programs (PAPs)
Understanding Prescription Assistance Programs (PAPs) The use of prescription medicines has become an increasingly important part of quality medical care. Two out of every three visits to the doctor end
More informationMedicare and Your Mental Health Benefits CENTERS FOR MEDICARE & MEDICAID SERVICES
CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare and Your Mental Health Benefits This is the official government booklet about Medicare mental health benefits for people in the Original Medicare Plan.
More informationEssentials Rx 15 (HMO) Plan offered by PacificSource Medicare. Annual Notice of Changes for 2014
Essentials Rx 15 (HMO) Plan offered by PacificSource Medicare Annual Notice of Changes for 2014 You are currently enrolled as a member of Essentials Rx 15 (HMO) Plan. Next year, there will be some changes
More information2015 HMO Evidence of Coverage
hap.org/medicare 2015 HMO Evidence of Coverage HAP Senior Plus (hmo)-henry Ford Individual Plan 006 Option 1 Your Medicare Health Benefits and Services as a Member of HAP Senior Plus (hmo)-henry Ford.
More informationCopayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service.
Basic Terms How to calculate Out of Pocket Costs on a Hospital Stay: If you have a $2000 deductible and 30% coinsurance health insurance plan. If you have a $10,000 emergency room or hospital stay your
More informationPowered by iassist. User Guide and FAQs
User Guide and Helpful information about, how to use the platform, and answers to some frequently asked questions () Table of Contents Click an option below to get started Setting up your account eprescribing
More informationEVIDENCE OF COVERAGE
Samaritan Advantage Health Plan (HMO) EVIDENCE OF COVERAGE Conventional Plan 2016 H3811_MM170_2016B Form CMS 10260-ANOC/EOC OMB Approval 0938-1051 (Approved 03/2014) January 1 December 31, 2016 Evidence
More informationFinancial Information for Kidney and/or Pancreas Transplantation
Financial Information for Kidney and/or Pancreas Transplantation Transplantation is an expensive treatment for kidney and/or pancreas disease and it is important for you to plan ahead and be well informed
More informationInsurance Trust for Delta Retirees 2013 Prescription Drug Plan (PDP)
Your Plan Explained Insurance Trust for Delta Retirees 2013 Prescription Drug Plan (PDP) UnitedHealthcare MedicareRx for Groups (PDP) Y0066_PDP_896487_000 What is Medicare Part D? Medicare Part D is a
More informationTelemedicine Frequently Asked Questions (FAQs) For Highmark Delaware Members
Table of Contents Telemedicine Frequently Asked Questions (FAQs) For Highmark Delaware Members Overview and Eligibility.....Pages 1-3 Member Out-of-Pocket Costs......Pages 3-4 Amwell and Doctor on Demand
More informationFINANCES AFTER STROKE GUIDE
FINANCES AFTER STROKE GUIDE FINANCES AFTER STROKE GUIDE The American Stroke Association s Finances After Stroke Guide provides information and resources that can help you immediately after a stroke. You
More informationMake sure you re covered for your biologic medicine!
It s open enrollment time Make sure you re covered for your biologic medicine! Joint Decisions is brought to you by Janssen Biotech, Inc., in partnership with CreakyJoints CreakyJoints Bringing arthritis
More informationCo-Pay Assistance Program for CUBICIN (daptomycin for injection) for Intravenous Use Enrollment Form
1. PATIENT INFORMATION Name Gender: o Male o Female Date of Birth: / / Address City State ZIP Email Home Phone Cell Phone Work Phone Alternate Contact Person (Optional) Alternate Phone Number (Optional)
More information2016 HIV Pre-Exposure Prophylaxis (PrEP) Health Insurance Assessment
2016 HIV Pre-Exposure Prophylaxis (PrEP) Health Insurance Assessment December 2015 Report produced by: Cesar Egurrola Clinical Coordinator Petersen Clinics Shannon Smith Director, Special Projects Department
More informationUpdated as of 05/15/13-1 -
Updated as of 05/15/13-1 - GENERAL OFFICE POLICIES Thank you for choosing the Quiroz Adult Medicine Clinic, PA (QAMC) as your health care provider. The following general office policies are provided to
More informationChoosing a Medicare prescription drug plan.
Choosing a Medicare prescription drug plan. Medicare Made Clear TM Get Answers Series Look inside to: Learn about Part D prescription drug coverage options Find out what you need to know about the Part
More informationYour Pharmacy Benefit: Make it Work for You!
Your Pharmacy Benefit: Make it Work for You! www.yourpharmacybenefit.org Table of Contents Choose Your Plan.............................................2 Steps in Choosing Your Pharmacy Benefits.........................
More informationMICHIGAN PUBLIC SCHOOL EMPLOYEES RETIREMENT SYSTEM
MICHIGAN PUBLIC SCHOOL EMPLOYEES RETIREMENT SYSTEM 2015 Health Plan Seminar Medicare Plus Blue is a PPO plan with a Medicare contract. Enrollment in Medicare Plus Blue depends on contract renewal. H9572_S_15MPSERSSem
More informationMedical and Rx Claims Procedures
This section of the Stryker Benefits Summary describes the procedures for filing a claim for medical and prescription drug benefits and how to appeal denied claims. Medical and Rx Benefits In-Network Providers
More informationAnnual Notice of Changes for 2015
Prescription Blue SM PDP, Option B, offered by Blue Cross Blue Shield of Michigan Annual Notice of Changes for 2015 You are currently enrolled as a member of Prescription Blue Option B. Next year, there
More informationCustomized Patient Care through Patient Support Programs for Rare/Orphan Drugs. Sandra Anderson August 2015
Customized Patient Care through Patient Support Programs for Rare/Orphan Drugs Sandra Anderson August 2015 Why Orphan Drugs are Different Difficult to diagnose Population size Unique patient and caregiver
More informationIndividualizing Your Lung Cancer Care: Informing Decisions Through Biomarker Testing
Individualizing Your Lung Cancer Care: Informing Decisions Through Biomarker Testing These Are Hopeful Times for Lung Cancer Survivors When people first learn they have cancer, they are often afraid. But
More informationAnnual Notice of Changes for 2015
Express Scripts Medicare (PDP) for Consolidated Associations of Railroad Employees (CARE) Annual Notice of Changes for 2015 You are currently enrolled as a member of Express Scripts Medicare (PDP). The
More informationGetting started with Medicare.
Getting started with Medicare. Medicare Made Clear TM Get Answers: Medicare Education Look inside to: Understand the difference between Medicare plans Compare plans and choose the right one for you See
More informationAnnual Notice of Changes for 2016
Healthy Advantage Plus HMO offered by Molina Healthcare of Utah Annual Notice of Changes for 2016 You are currently enrolled as a member of Healthy Advantage Plus HMO. Next year, there will be some changes
More informationTRUSTED PATIENT EDUCATION FOR BETTER OUTCOMES. MICROMEDEX Patient Connect. Patient Education & Engagement
TRUSTED PATIENT EDUCATION FOR BETTER OUTCOMES MICROMEDEX Patient Connect Patient Education & Engagement Trusted Patient Education for Better Outcomes All your training, experience, tools, and technology
More informationGuide to Purchasing Health Insurance
Guide to Purchasing Health Insurance What are your health insurance choices? Which type is right for you? Sample questions Looking for insurance in specific situations Tips for shopping for health coverage
More informationYour Retiree Health Care Travel Guide
SPECIAL EDITION for Individuals Not Yet Eligible for Medicare Your Retiree Health Care Travel Guide 2010 Enrollment for BorgWarner Pre-Medicare Health Care Coverage Welcome to 2010 Pre-Medicare enrollment!
More informationAnnual Notice of Changes for 2015
BlueRx (PDP) Local Government Health Insurance Plan (LGHIP) Prescription Drug Coverage for Medicare Members offered by Blue Cross and Blue Shield of Alabama Annual Notice of Changes for 2015 You are currently
More informationParamount Elite Standard Medical and Drug (HMO) offered by Paramount Care, Inc.
Paramount Elite Standard Medical and Drug (HMO) offered by Paramount Care, Inc. Annual Notice of Changes for 2016 You are currently enrolled as a member of Paramount Elite Standard Medical and Drug (HMO).
More informationAbout the Program 1. What is the current Osphena (ospemifene) Savings Offer for 30 day prescription?
2015 Osphena Savings Program Frequently Asked Questions Click here for Full Prescribing Information, including Boxed WARNING regarding Endometrial Cancer and Cardiovascular Disorders. Have a question about
More informationSMART Humana Group Medicare
SMART Humana Group Medicare Group Medicare GHHHNYFEN 0813 Overview of Humana Medicare Medicare is the largest government-sponsored health insurance program in the United States, serving more than 49 million
More informationExpress Scripts Medicare TM (PDP) through State of Delaware Medicare Retiree Prescription Plan Frequently Asked Questions
Express Scripts Medicare TM (PDP) through State of Delaware Medicare Retiree Prescription Plan Frequently Asked Questions Section 1 General Information (Questions 1-5) Section 2 Enrollment Information
More informationHealth Insurance A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. HL-14-001 Rev. 08/2015
A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE The of Health Insurance wahealthplanfinder.org 1-855-WAFINDER 1-855-923-4633 HL-14-001 Rev. 08/2015 THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH
More informationSNHPI Safety Net Hospitals for Pharmaceutical Access
SNHPI Safety Net Hospitals for Pharmaceutical Access Why the 340B Program Will Continue to be Important and Necessary after Health Care Reform is Fully Implemented Since 1992, the 340B drug discount program
More informationSelf-Insured Schools of California: SISC PPO (HSA Eligible)
Helping SISC III SELF-INSURED SCHOOLS OF CALIFORNIA Self-Insured of California: Helping SISC PPO (HSA Eligible) Administered by Blue Shield of California 2013/2014 Enrollment Guide Blue Shield of California
More informationAnnual Notice of Changes for 2016
Upper Peninsula Health Plan Advantage (HMO) offered by Upper Peninsula Health Plan, LLC Annual Notice of Changes for 2016 You are currently enrolled as a member of Upper Peninsula Health Plan Advantage
More information