Patient Assistance & Reimbursement Guide

Oncology-Related Product

Company

Coverage

• Commercial/Private Patients who have private or commercial insurance through their employer as well as those with a health exchange or Marketplace plan.
• Government Any federal-, state-, or government-funded healthcare program (i.e., Medicare, Medicare Advantage, Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DoD), or TriCare).
• Uninsured/Underinsured Any patients who are self pay or who have no healthcare insurance as well as those whose insurance does not cover the prescribed product.

Assistance Type

• Co-Pay Card/Out-Of-Pocket Cost Assistance These programs are manufacturer based and can provide assistance with co-pays, coinsurance, and out-of-pocket costs.
• Dose Exchange Program These programs help patients who have been prescribed a new dosage of their medication.
• Independent Charitable Foundations/Organizations These programs allow manufacturers to refer you to an independent, charitable organization that may, or may not, be associated with it.
• Insurance Coverage-Related Delay Program These programs help patients who experience a delay in coverage, so they can start their prescriptions or therapy immediately.
• Patient Assistance Program These programs often provide patients' prescriptions at no cost and can be known as free drug or replacement drug programs.
• Product Replacement Program These programs can replace an unused or spoiled/mishandled product and may be part of a manufacturer's offered patient assistance program.
• Reimbursement Assistance These programs may include assistance with benefits verification, prior authorization, and appeals or denials.