Understanding the Coverage Process
Here are tips to help you understand the coverage process.
The insurance verification process can be complicated. The VELCADE Reimbursement Assistance Program is here to help. You can contact a dedicated Case Manager from 8:00 am to 8:00 pm EST Monday through Friday at 1-866-VELCADE (835-2233), option 2, who will help you navigate this process.
Four Steps to Access VELCADE® (bortezomib)
Step 1 – Talk to Your Doctor
Discuss any questions you may have regarding treatment and the impact it will have on your out-of-pocket expense with your doctor and the office staff.
Your doctor’s office is a resource for you about what to expect from your treatment and how different treatment regimens may be impacted by your insurance coverage. They can also refer you to other resources that may be useful to you.
You can contact the VELCADE Reimbursement Assistance Program (VRAP) at 1-866-VELCADE (835-2233), option 2, from 8:00 am to 8:00 pm EST, Monday through Friday.
Step 2 – Provide Insurance Information to Your Doctor’s Office
Make sure that your doctor's office has all of your current insurance information so that they can verify your coverage and provide your insurance company with any additional information they need.
Your doctor's office will research your insurance coverage to determine if VELCADE will be covered, if additional documentation will need to be submitted to the insurance company, and how much you will need to pay for your treatment based on your insurance plan.
- If your insurance company covers VELCADE, you will move on to the payment and scheduling processes outlined in steps 3 and 4
- If your insurance company requests additional information, then your doctor may need to submit a letter stating the reason(s) why you need to be treated with VELCADE. The insurance company will notify both you and the doctor about their decision. If coverage is approved, you will move on to the payment and scheduling processes outlined in steps 3 and 4
- If your insurance company requests additional information and does not approve your treatment based on what your doctor has provided, then you may be able to get assistance through the VELCADE Reimbursement Assistance Program (VRAP)
Step 3 – Understand the Payment Process
Depending on the details of your specific insurance coverage, your out-of-pocket expense will vary. It is important to understand these details, and to know where you can go for help.
As a result of the insurance verification process, you and your doctor's office will know whether you have insurance coverage for your VELCADE treatment and how much you will be responsible for paying, according to your insurance policy.
Insured
If your insurance company covers VELCADE and you either have a supplemental policy or can self-pay to cover the co-payment, then treatment will begin as soon as it can be scheduled.
Underinsured
If you are unable to afford your co-payment, then you can apply to a Co-payment Foundation for assistance. You will need to fill out an enrollment form in order to be evaluated for assistance by the foundation. The VELCADE Reimbursement Assistance Program (VRAP) can help you identify the foundations that cover your diagnosis and assist you with the form. Your doctor's office may also be able to help you with this process. If you are approved for assistance from the Co-payment Foundation, they will notify you of the amount they will give you for your treatment. Here is a list of some of the organizations that may be able to offer assistance:
Patient Advocate Foundation
www.patientadvocate.org
Phone: (800) 532-5274
Patient Access Network Foundation
panfoundation.org
Phone: (866) 316-7263
Chronic Disease Fund
www.cdfund.org
Phone: (877) 968-7233
Leukemia and Lymphoma Society
www.lls.org
Phone: (800) 955-4572
HealthWell Foundation
healthwellfoundation.org
Phone: (800) 675-8416
The Assistance Fund
www.theassistancefund.org
Phone: (877) 245-4412
Uninsured
If you have no insurance coverage, then you may be eligible for VRAP. You or your doctor's office can call VRAP and pre-screen to see if you qualify for the program. You and your doctor will have to fill out a one-page form, provide financial documentation and fax the information to VRAP. Within 48 hours, you will know whether you can get free drug for your treatment.
Step 4 – Schedule Your Treatment
Once you have determined how you will be able to pay for VELCADE, contact your doctor's office to schedule your VELCADE treatment.
Once your insurance coverage for VELCADE has been verified, you will set up an appointment to receive your VELCADE therapy. VELCADE is given as a 3- to 5-second IV injection in your doctor’s office or at a hospital out-patient clinic.
Need Additional Resources?
You also have many other resources that can assist you and your family throughout your treatment. These resources can provide assistance with treatment-related costs, help you identify support groups for yourself and other family members, and partner with your doctor and insurance company to get coverage for your treatment.
VELCADE Reimbursement Assistance Program (VRAP)
1-866-VELCADE (835-2233), Option 2
8:00 am to 8:00 pm EST, Monday through Friday
Patient Advocate Foundation
www.patientadvocate.org
Phone: (800) 532-5274
CancerCare
www.cancercare.org
Phone: (800) 813-4673
Patient Access Network Foundation
www.panfoundation.org
Phone: (866) 316-7263
Chronic Disease Fund
www.cdfund.org
Phone: (877) 968-7233
Leukemia & Lymphoma Society
www.lls.org
Phone: (800) 955-4572
Healthwell Foundation
www.healthwellfoundation.org
Phone: (800) 675-8416
VRAP is available to you to provide assistance regarding these and other insurance coverage questions.
NEXT: Questions to Ask Your Doctor’s Office
The process of paying for healthcare services, supplies, and medications. Insurance plans, the government, and patients reimburse healthcare providers and pharmacies for the services and products they provide
Fixed amount of money a patient is responsible for at each doctor’s visit, at the hospital or emergency room, or when a prescription is filled at a pharmacy (i.e. $10, $20, etc.). Amounts defined by the patient’s insurance benefit structure.
Intravenous injection; a method of administering drugs or fluids using a needle or a thin tube inserted in a vein; IV push denotes that the process happens quickly, within seconds, while the IV infusion may take many hours