OK, I’m curious. But what does coverage look like?

Understanding the insurance process can make a difference.

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Benefits verification

The first step in the process is for your doctor’s office to do a benefits verification on your behalf. They will work with your insurance company to determine if CUVITRU is covered under your health plan, how much insurance will pay, what your deductible will be, and how much you will pay out of pocket. Once the office receives information, ask the office manager to review your benefits verification results with you. This will help you fully understand what you are responsible for.

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Prior authorization

Next, your doctor has to show your health plan that CUVITRU is the appropriate treatment for you based on your medical profile. This is called a prior authorization. Your doctor’s office will send the necessary forms and documents. Once your insurance company reviews the prior authorization, you and your doctor’s office will be notified if you are approved for therapy.

Sometimes, these processes will be managed by a specialty pharmacy provider (SPP). Your SPP may contact you to coordinate these steps.

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For those who are enrolled in Takeda

Patient Support, specialists are never more than a tap or a call away.

1-855-268-1825

Monday through Friday, 8 AM to 8 PM ET

 

Enroll today.

Working with your specialty pharmacy to get CUVITRU

CUVITRU is a specialty drug, which means you can’t pick up your prescription at the local pharmacy. Specialty pharmacy providers (SPPs) carry drugs for rare conditions such as primary immunodeficiency and make sure they are stored and handled appropriately before they are shipped. Your doctor will order CUVITRU through an SPP, and it will be delivered to your preferred location.

Here’s what to expect when working with an SPP: 

  • Specialty pharmacies are able to support you by working directly with your insurance company to find out how your health plan covers CUVITRU. They can assist with steps in the approval process, such as benefits verification, prior authorization, financial assistance, and treatment education
    • You can expect an SPP to contact you after a physician prescribes you CUVITRU
  • SPPs will coordinate delivery of CUVITRU. Depending on your discussion with your doctor, you will have CUVITRU delivered to your home or an infusion center
  • Some insurance companies may only work with certain specialty pharmacies. Currently, only the below SPPs have CUVITRU in stock. Work with your doctor’s office or an insurance representative to determine which SPP is available to you

The following SPPs are currently authorized to dispense CUVITRU:

  • Accredo Specialty Pharmacy
  • Advanced Infusion Care
  • AllianceRx Walgreens Pharmacy
  • AOM Infusion
  • Amerita
  • Avevo RX, LLC
  • Axiva Health Solutions
  • BioMatrix 
  • BioPlus
  • BioTek Remedys
  • Coastal Infusion Services 
  • ContinuumRx 
  • CSI Pharmacy
  • CVS Health
  • InfuCare Rx
  • Intramed Plus
  • KabaFusion
  • Kroger Specialty Infusion
  • Nufactor
  • Option Care Health
  • Optum Infusion Pharmacy
  • Paragon Healthcare
  • Promptcare
  • Realo Specialty Care Pharmacy
  • Soleo Health
  • Superior Biologics 
  • TwelveStone Health Partners 
  • Upstate HomeCare 
  • Vital Care

 

Inquire with specific SPPs for current status.

Making the most of your training with a nurse

Here are a few tips that can help training with your nurse be the most beneficial.

  • Allow your vials to reach room temperature. This could take up to 90 minutes 
  • Do not apply heat or microwave
  • Have a clean, open workspace, such as a counter or table, where you can lay out your supplies
  • Gather your box of supplies from the specialty pharmacy and your CUVITRU starter kit (if you received a kit)
  • Ensure the manufacturer’s instructions for your pump are handy
  • Write down any questions you may have for the nurse. With so much new information, these questions can easily be forgotten. If you received the CUVITRU starter kit, there’s a Wellness Journal included, and it has space to jot down questions and notes

Extra supplies you may want to have on hand:

  • Antihistamines or epinephrine
  • Antibacterial wipes for cleaning surfaces
  • Antibacterial soap

Most importantly, try to relax and know that the nurse is here to help you. You’ll feel more familiar with your supplies and the infusion process after your training. You can do this!

Know what to expect.

Watching our infusion video before your training will help you prepare for your nurse visit.