Most insurance companies have added at least one or two of these CGRP inhibitors to the list of medicines they cover, but individual patients are still struggling to get the insurers to approve coverage of their prescribed CGRP inhibitor. Each pharmaceutical company is offering financial assistance programs to help help cover the cost of high copays. Each program is different and various programs exist to support patients with private, goverment-funded insurance, as well as the uninsured.
To help patients understand each program, the Coalition For Headache And Migraine Patients (CHAMP) has created Financial Assistance Guides for the three CGRP inhibitors. These guides have not been produced or approved by the medication manufacturers. CHAMP is not endorsing the use of any CGRP inhibitor over another, nor promoting the use of this new class of preventive medications for everyone with migraine disease. Every patient needs to consult their healthcare provider to determine if CGRP inhibitors are right for you.
I Have Been Prescribed gammaCore. What Financial Assistance Programs Exits To Help Me?
Find your insurance coverage and see what Financial Assistance Programs exist to help.
I Have a Private/Commercial Insurance Plan
This category includes insurance plans provided through an employer, purchased with subsidy support from the Affordable Care Act (Obamacare) or purchased privately.
Highlights of Teva Savings Card
If you have commercial drug insurance and it covers Ajovy, you may be able to pay as little as $5 for your Ajovy. The program currently extends through December 2020. The Savings Card is subject to a maximum annual limit of $3500. This means that you may be required to pay out of pocket depending on your health plan and copay model if the maximum annual cap is reached.
This program is managed by ConnectiveRx on behalf of Teva. Teva reserves the right to make eligibility determinations, to set offer benefit maximums, to monitor participation, and to change, rescind, revoke or discontinue this offer at any time without notice.
Steps to Receive Co-Pay Assist Savings Offer
Congratulations on accessing your first dose of Ajovy!
Teva will now be working behind the scenes to get your doctor to complete a prior authorization form and to get your insurance company to cover your Ajovy prescription. To be a proactive and engaged patient, you should contact your doctor’s office to see if they have completed the Ajovy prior authorization form on your behalf and your insurance company to see if they will be covering your prescribed medicine. If you have questions or encounter problems, contact Teva Shared Solutions at 1-800-887-8100
I Have Medicare, Medicaid or other Government Insurance Plan
At this time electroCore does not have a financial assistance program for those with Medicare, Medicaid or other government insurance plans.
Veterans associated with a VA facility
gammaCore is available at no cost to the veteran since the device is contracted on the Federal Supply Schedule. A VA health care provider should submit an order for gammaCore to their facility’s prosthetics department who will process and submit a PO by fax to electroCore. Please call 1-888-903-2673 for more information.
Active military personnel associated with a military treatment facility (MTF)
gammaCore is available at no cost to the active duty military member since the device is contracted on the Federal Supply Schedule and DAPA. A MTF health care provider should submit an order through DMLSS. Please call 1-888-903-2673 for more information.
I Am Uninsured
For those without commercial insurance, electroCore™ has a Co-pay Assist program. Through Co-pay Assist, qualified patients may be eligible to receive co-pay assistance of up to $300 on the first month and up to $250 for each following month for a maximum of 12 months. To learn more go to: gammaCore.com/patient-support/.
Where Do I Turn If I need More Help?
The Patient Advocate Foundation (a CHAMP member organization) can be a helpful resource for patients and caregivers who are experiencing access challenges. PAF provides a suite of expert tips to help navigate insurance denials, appeals and common barriers at: patientadvocate.org/migrainematters.
PAF also offers one-on-one case management assistance through its dedicated Migraine Careline for people living with migraine who experience access challenges. The Migraine Careline provides assistance with navigating eligibility and enrollment in disability benefits and overcoming insurance coverage and financial burdens that impact patient access to care. All services are completely free and provided through phone and/or email communication. Visit migraine.pafcareline.org or call 866-688-3625 to speak with a case manager today.