Celgene Corporation offers patient support through the Celgene Patient Support program. This program offers eligible patients a range of support services to access Celgene medications (Table), regardless of their insurance status.
Celgene Patient Support
In addition, the Celgene Patient Support program provides assistance with navigating insurance and reimbursement issues, including initiating benefits investigations, and assisting with prior authorizations and appeals processes.
Patients prescribed Celgene medications may be eligible for the following support programs:
- Patients with commercial (or private) insurance may be eligible for the Celgene Commercial Co-pay Program
- Uninsured or underinsured patients may be eligible for free medications through the Celgene Free Medication Program
- Patients prescribed certain Celgene medications may be eligible for free medications through the Celgene Replacement Medication Program after insurance denial and unsuccessful appeal
- For patients with Medicare, Medicaid, or any other type of government-sponsored insurance, Celgene Patient Support offers information about funding through independent organizations.
A dedicated Celgene Patient Support Specialist is assigned to each practice to provide personal service in accessing Celgene medications.
Celgene Commercial Co-pay Program
Through this program, the patient’s cost will be $25 or less for eligible patients, depending on the Celgene drug, with the maximum assistance for a patient not to exceed $10,000.
To be eligible for the Celgene Commercial Co-pay Program, patients must:
- Reside in the United States or Puerto Rico
- Have a commercial or private (not Medicare, Medicaid, or another government-sponsored program) insurance
- Have an annual household income of $100,000 or less.
Celgene Free Medication ProgramEligibility for the Celgene Free Medication Program is based on the patient’s insurance and financial criteria, primarily the total household annual income and assets.
Celgene Replacement Medication Program
Patients receiving intravenous Celgene drugs may qualify for free replacement medicine after an unsuccessful appeal if they meet specific financial and insurance eligibility criteria.
Financial Assistance Through Independent Third-Party Organizations
For patients with Medicare, Medicaid, or any other type of government-sponsored insurance, Celgene Patient Support offers information about funding through independent organizations.
For more information about options for patients with government-sponsored insurance, call Celgene Patient Support, at 800-931-8691.
Application & Enrollment
The completion of the Patient Assistance Application is required for 3 reimbursement services, including uninsured and underinsured patient assistance/free drug, appeals assistance, and Celgene Commercial Co-pay Program (for intravenous drugs only). For all other services, please contact Celgene Patient Support for assistance.
Enrollment forms for Celgene Patient Support programs are available at www.celgenepatientsupport.com/hcp/enroll-now. Applications may be faxed to 800-822-2496 or e-mailed to firstname.lastname@example.org. Patients can also be enrolled over the phone by calling 800-931-8691, or at www.celgenepatientsupport.com/hcp/enrollment.
The patient or the patient’s representative and the physician or healthcare provider must sign the relevant sections of the form. The physician or healthcare provider must provide the patient’s clinical information, including the diagnosis code, drug dosage used, the number and name of any previous therapies received, as well as any combination treatment that included a Celgene drug (if applicable).
In addition, a copy of the patient’s insurance card must be submitted along with the application form.
Income is determined based on the patient’s salary or wages, earnings from dividends and rental properties, disability compensation, pension, and Social Security.
Assets are determined based on the patient’s savings, checking, and money market accounts; credit default swap; and the estimated market values of their individual retirement accounts, stocks, mutual funds, and bonds.
A random audit may be done to verify the applicant’s household income and asset information.
Receiving Celgene Medications
Because of the risks associated with certain medications, some Celgene drugs are only available through a restricted distribution program, the Risk Evaluation and Mitigation Strategies (REMS) program.
Prescriptions for drugs that require restricted distribution must be filled at select pharmacies to comply with the REMS program.
For Celgene drugs that are available through restricted distribution programs, Celgene Patient Support can provide information about Fast Track for First Prescription or finding a network pharmacy.
To learn more about the Celgene REMS programs, call 888-423-5436 or visit www.CelgeneRiskManagement.com.
Celgene Patient Support provides additional services, including:
- Assistance with navigating insurance and reimbursement issues, such as initiating benefits investigations and assisting with prior authorizations and appeals process
- Help in determining if patients qualify for the Medicare Low-Income Subsidy
- Assisting patients with the cost of traveling to doctors’ appointments.