2013 Patient Assistance and Reimbursement Guide - Association of ...
2013 Patient Assistance and Reimbursement Guide - Association of ...
2013 Patient Assistance and Reimbursement Guide - Association of ...
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Amgen, Inc.<br />
34<br />
www.amgen.com<br />
Oncology-related products: Aranesp ® (darbepoetin alfa), Epogen ®<br />
(epoetin alfa), Neulasta ® (pegfilgrastim), Neupogen ® (filgrastim),<br />
Nplate ® (romiplostim), Prolia ® (denosumab), Sensipar ® (cinacalcet),<br />
Vectibix ® , (panitumumab), Xgeva (denosumab)<br />
<strong>Patient</strong> <strong>and</strong> <strong>Reimbursement</strong><br />
<strong>Assistance</strong> Website<br />
www.amgenassistonline.com<br />
<strong>Patient</strong> <strong>Assistance</strong><br />
Commercial Co-Pay <strong>Assistance</strong><br />
Coupon Support<br />
Amgen <strong>of</strong>fers co-pay coupon programs<br />
for Neulasta ® , Nplate ® , <strong>and</strong> Xgeva<br />
to help eligible patients who are commercially<br />
insured with their deductible,<br />
co-insurance, <strong>and</strong>/or co-payment requirements.<br />
To confirm your eligibility <strong>and</strong><br />
enroll in one <strong>of</strong> these programs, please<br />
call 1.888.65.STEP1 (888.657.8371) or<br />
visit www.amgenfirststep.com.<br />
Co-Pay Support<br />
<strong>Patient</strong>s who are commercially <strong>and</strong> government<br />
insured (including Medicare),<br />
but need financial assistance, can be<br />
referred to independent non-pr<strong>of</strong>it co-pay<br />
foundations. Amgen makes donations to<br />
these foundations that, in turn, help qualifying<br />
insured patients with out-<strong>of</strong>-pocket<br />
costs, including co-payments <strong>and</strong> premiums,<br />
to cover the medicines they need.<br />
●●<br />
●●<br />
●●<br />
HealthWell ® Foundation<br />
(www.healthwellfoundation.org)<br />
<strong>Patient</strong> Advocate Foundation<br />
(www.patientadvocate.org)<br />
<strong>Patient</strong> Access Network<br />
(www.panfoundation.org)<br />
Uninsured <strong>Patient</strong>s<br />
The Safety Net Foundation is a non-pr<strong>of</strong>it<br />
patient assistance program that helps<br />
qualifying uninsured patients access<br />
Amgen medicines at no cost. <strong>Patient</strong>s<br />
may be able to receive Amgen medications<br />
at no cost from The Safety Net<br />
Foundation if they meet the following<br />
eligibility requirements:<br />
●●<br />
Are a resident <strong>of</strong> the US or its<br />
territories<br />
●●<br />
●●<br />
●●<br />
Satisfy income eligibility requirements<br />
Have no or limited drug coverage<br />
Do not have any other insurance<br />
options. Note: Qualifying Medicare<br />
Part D patients may also be eligible.<br />
To enroll in The Safety Net Foundation,<br />
patients must complete the <strong>Patient</strong> Application<br />
Form in English (www.safetynetfoundation.com/pdf/SNF_<strong>Patient</strong>_Application_08012012_v3_FINAL.pdf)<br />
or<br />
Spanish (www.safetynetfoundation.com/<br />
pdf/SNF_<strong>Patient</strong>_Application_Spanish_08012012_v1_FINAL.pdf)<br />
<strong>and</strong> meet<br />
program eligibility requirements. For<br />
prospective model products, the patient<br />
can apply directly to the Foundation. Providers<br />
do not need to be enrolled in the<br />
Foundation for prospective products.<br />
Take this online course <strong>and</strong> learn about<br />
the insurance process from two perspectives<br />
as an advocate at a non-pr<strong>of</strong>it<br />
foundation <strong>and</strong> a practice manager in a<br />
cancer program share their combined<br />
knowledge about:<br />
■■<br />
■■<br />
■■<br />
The Medicare <strong>and</strong> Medicaid<br />
programs, MAC carriers, <strong>and</strong> the<br />
Part D drug benefit, including<br />
the “donut” hole <strong>and</strong> its effect on<br />
patients.<br />
The prescription drug benefits<br />
<strong>of</strong> private payers, such as drug<br />
formularies <strong>and</strong> drug tiers.<br />
Benefit verification, secondary<br />
benefits, prior authorizations,<br />
re-authorizations, <strong>and</strong> more.<br />
For drug replacement, the provider<br />
must apply to the Foundation on the<br />
patient’s behalf. The provider must first<br />
enroll in the Foundation before they can<br />
enroll a patient. Download the Facility<br />
Application form in English (www.<br />
safetynetfoundation.com/pdf/SNF_Facility_Application_08012012_v2_FINAL.<br />
pdf ) or Spanish (www.safetynetfoundation.com/pdf/SNF_<strong>Patient</strong>_Application_Spanish_08012012_v1_FINAL.pdf.<br />
Once enrolled, providers can complete<br />
the Product Replacement Request Form<br />
(www.safetynetfoundation.com/pdf/<br />
SNF_Product_Replacement_Request_<br />
Form_08012012_v2_FINAL.pdf).<br />
Institutions that have enrolled as Individual<br />
<strong>Patient</strong> <strong>Assistance</strong> Program (IPAP)<br />
facilities may use the IPAP <strong>Patient</strong> Application<br />
to enroll their patients. The form is<br />
available in both English (www.safetynetfoundation.com/pdf/SNF_IPAP_<strong>Patient</strong>_<br />
Application_08012012_v2_FINAL.pdf)<br />
<strong>and</strong> Spanish (www.safetynetfoundation.<br />
com/pdf/SNF_IPAP_<strong>Patient</strong>_Application_08012012_v2_FINAL.pdf).<br />
Questions Call 1.888.762.6436.<br />
REIMBURSEMENT ASSISTANCE<br />
Amgen Assist ® Online<br />
Amgen Assist Online gives patients <strong>and</strong><br />
healthcare providers a single destination<br />
for access to online services <strong>and</strong> forms,<br />
<strong>and</strong> makes it easier to find a program that<br />
would best meet each patient’s unique<br />
needs.<br />
Underst<strong>and</strong>ing the Insurance Process<br />
■■<br />
■■<br />
■■<br />
How to estimate the patient’s<br />
responsibility, including co-pays<br />
<strong>and</strong> deductibles.<br />
The appeals process.<br />
Disability, including eligibility,<br />
the application process, <strong>and</strong><br />
coverage.<br />
Register at: www.accc-cancer.org/<br />
education/FinancialCounseling-<br />
Courses.asp. This course is part<br />
<strong>of</strong> ACCC’s Financial Information<br />
<strong>and</strong> Learning Network educational<br />
program.<br />
<br />
ACCC <strong>2013</strong> <strong>Patient</strong> <strong>Assistance</strong> <strong>and</strong> <strong>Reimbursement</strong> <strong>Guide</strong>
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