Newsletter: Health Coverage

The following is the latest free newsletter fron "The Transplant Experience," the educational division of Astellas Pharmaceuticals, maker of several post transplant meds. The newsletters help educate patients about the many aspects involved with pre and post transplant lives.

"Make the Most of Your Healthcare Coverage"

The medical care before transplantation and necessary for your long-term transplant health is a lifelong expense that you and your transplant team will need to manage. To this end, making sure your medical coverage is right for where you are in your individual transplant journey is very important. Since your needs may change with time, it’s a good idea to revisit your coverage options and to make sure you’re using the financial resources available to you. Here are a few tips to get you started:


Understand both the medical and nonmedical expenses associated with transplantation—from the co-payment for your laboratory tests to the cost of transportation to your transplant center.

 For a full list of transplant costs you should be aware of, visit the
"Financing a Transplant" page on the Transplant Living website.


Learn about insurance basics as well as what differentiates various insurance types (Medicare, HMO, PPO, etc.).


 For a breakdown of the different health insurance plans, visit the Insurance Coverage pages under the Support section of www.TransplantExperience.com.


Contact your insurance provider or meet with your transplant financial coordinator to address any concerns you may have or to help you plan your next steps.


 For a list of key financial questions to ask both pre- and post-transplant, visit the Questions to Ask page under the Support section of www.TransplantExperience.com.

Financial Assistance and Astellas
Some pharmaceutical companies, like Astellas Pharma US, Inc., offer programs to accommodate a wide range of financial situations. Genevieve Mylott, Assistant Director of Reimbursement Strategy for Astellas Reimbursement ServicesSM (ARS), understands there are “many moving parts” to getting the healthcare coverage you need. ARS can help with the process. If your doctor intends for you to receive Prograf® (tacrolimus) capsules, ARS can work with a member of your transplant team to help you:

• Understand the specific benefits of your plan

• Take advantage of out-of-pocket assistance programs for Prograf

• Gain/understand prior authorizations for Prograf

• Appeal denied claims

According to Genevieve, the most important thing you can do is communicate your financial concerns to members of your transplant team, who act as the main conduit between you and an ARS representative. In addition to keeping a record of your insurance information, they can guide you, or apply on your behalf, to financial assistance programs offered by Astellas—such as the Prograf: Value Card or the Astellas Access ProgramSM (AAP).

ARS: Facilitating Access to Your Medications
Financial barriers should not prevent you from receiving the medications intended for you by your doctor. That is why Astellas offers the AAP, which provides a full year’s supply of brand name Prograf to those demonstrating a gross household income below 2.5 times the poverty line.

To learn more about eligibility and application criteria for the AAP, as well as other services ARS has to offer, visit the Patient section of
www.astellasaccess.com.

Not registered with Transplant Experience? Join today at www.TransplantExperience.com.

The information that Astellas Pharmaceutical provides has been entirely invaluable to me. I urge anyone who is going through anything similar to what I am to subscribe to The Transplant Experience. You will be glad that you did!