Applying to and renewing co-pay foundation funding may be crucial in maintaining a proper care regimen among underinsured patients. “If it wasn’t for the
co-pay foundations like Patient Access Network, Genentech Access Solutions, Regeneron’s Eylea 4U, and Chronic Disease Fund, a good deal of our patients
wouldn’t have access to some of the best treatments available,” says Chris Hunckler, Contracting/Credentialing Manager, Retina Consultants of Houston.
Patients with chronic diseases, including RVO, wet AMD, DME and vitreomacular adhesion, can receive funding through several foundations or reduced cost
medications through pharmaceutical companies. “We recognize patients can face a variety of different challenges, including lack of insurance, reimbursement
issues, and high out-of-pocket costs,” says Charlotte Arnold, Associate Director of Corporate Relations at Genentech. “Donations to co-pay
foundations are an important part of how we work to support patients.”
Early Application, Early Renewal
Chronic care co-pay associations are funded through public and private donations to provide assistance to patients who would otherwise struggle with
insurance co-payments, co-insurance and deductibles. However, ensuring patients are able to access funds requires planning and guidance throughout the
process. For instance, Hunckler’s practice has a full-time staff member who “assists patients with the appropriate paperwork” and refers them to the
related websites. “She also verifies available funds for each patient who is scheduled for an appointment associated with a high-cost drug.”
Annual renewal may be required to receive ongoing funds, and must be submitted before the calendar or plan year begins. Foundations may send notices to
current patients alerting them to renew funding, “and we send reminder letters to our patients to complete renewal applications prior to the new year,”
says Hunckler. Funding also may be limited and allotted on a first-come-first-served basis, so patients should submit their requests early. “Some Disease
Funds run out of funding and will temporarily be closed to new applicants until additional funding is received,” says Hunckler.
Educating Patients
Eligibility varies by foundation, but often is based on whether the patient is insured or uninsured, diagnosed with a particular disease for which
treatments are covered by their insurance plans, and meeting income requirements, if necessary. Additionally, foundations may require proof of income,
often demonstrated with a social security statement or most recent tax return.
Payment assistance increases access to treatment options and improves continuity of care for a population who would likely forgo treatment due to cost, yet
many patients and practices are unaware of the assistance available. “Very few patients who I’ve come in contact with are familiar with the co-pay
assistance programs,” says Hunckler. “We do our best to educate them about the programs.”
Co-pay foundation options include:
-
Genentech’s Access Solutions (http://www.genentech-access.com) for support with insurance co-pays or
related costs
- Genentech’s Access to Care Foundation (GATCF) for prescriptions at no cost to patients; Patient Access Network Foundation (PANF)
(www.panfoundation.org) for assistance based on chronic disease category
-
Chronic Disease Fund
(www.cdfund.org) for financial access to medications and care
-
Regeneron’s Eylea 4U (www.eylea.us/index.php?id=4) for patient medications.