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Insurance and Patient Assistance
- 2. Introductions Danielle Burkett, CMA Danielle is a Certified Medical Assistant at Duke in the Pulmonary Vascular Disease Center. She has worked at Duke, with the PVDC, for 9 years. She works with Dr’s Fortin, Rajagopal, Dahhan, Whitson and Menachem. In her role, she assists with the process of accessing medications, prior authorizations and helps with financial aspects of obtaining PH medications. Laura Nowicki, RN Laura is a Registered Nurse at UNC Healthcare in Chapel Hill. She is one of the Pulmonary Hypertension Nurse Coordinators. She has been working exclusively with PH patients for 10 years. She works with Dr’s Ford, LeVarge, Rose-Jones and Ishizawar. In her role, she is responsible for all aspects of care for the PH patient. This includes the assistance with starting medications, ensuring access to medications as well as education and side effect management.
- 3. What we will cover today Common insurance terms Any Changes in insurance Patient Assistance Programs Time for Questions
- 4. Common Insurance terms and knowing the difference Employer, Marketplace (both aka Commercial), Medicaid and Medicare Part of Medicare A& D Premium vs Deductible Prior Authorization Step Therapy “Fail first”
- 5. Change in Insurance? Who do I need to tell about any change in insurance? Any and all Specialty Pharmacies. Your doctors office Why is it so important? Specialty Pharmacies need to know ASAP, they will run a benefit investigation and will be able to move forward in getting doctors office new information Doctors office will then have an idea that there was a change and can move forward with any process that needs to be done What can happen if I change? Your specialty pharmacy can change Your copay can change Your deductible can change
- 6. Patient Assistance Programs Managing Copay Assistance Applying for Patient Assistance Specialty Pharmacy PAF Manufacturer Patient Assistance
- 7. Financial Assistance Resources PAN Foundation Fund Finder www.funfinder.panfoundation.org Pulmonary Hypertension Association www.PHAassociation.org/HELP Health Well Foundation www.healthwellfoundation.org Patient Advocate Foundation www.copays.org Pan Foundation www.panfoundation.org The Assistance Fund www.TAFCares.org