Celgene Patient Support Services
Celgene Corporation offers patient support services for patients receiving Celgene medications through the Celgene Patient Support program. This program offers eligible patients a range of support services to access Celgene’s oncology drugs, regardless of their insurance status.
The drugs covered under this program are listed in the Table and include Abraxane (paclitaxel protein-bound particles for injectable suspension/albumin-bound) for injectable suspension, Idhifa (enasidenib), Pomalyst (pomalidomide), Revlimid (lenalidomide), Thalomid (thalidomide), and Vidaza (azacitidine).
Celgene Patient Support Services
Celgene Patient Support services provide patients the following services:
- A single specialist assigned to help patients in their geographic area
- Assistance with understanding patient insurance coverage for Celgene medications
- Information about financial assistance for the prescribed Celgene medication.
Celgene Patient Support services provide financial assistance options for patients with any insurance.
Celgene Commercial Co-pay Program
This program is available for eligible patients with commercial or private insurance (including healthcare exchanges). The program provides assistance to help patients meet their copay or coinsurance costs, and reduces the copay responsibility to $25 or less for the prescribed Celgene medication.
Celgene Patient Assistance Program
The Celgene Patient Assistance Program provides support for qualified patients who are uninsured or underinsured. Celgene medications may be available at no cost to patients who meet the insurance and financial criteria. Patients must meet specified financial and eligibility requirements to qualify for assistance under this program.
Independent Third-Party Organizations
For patients who are unable to afford their medication (including patients with Medicare, Medicaid, or other government-sponsored insurance), Celgene Patient Support can provide information about independent third-party organizations that may be able to help patients with the cost of deductibles, copayments and coinsurance, as well as insurance premiums. Financial and medical eligibility requirements vary.
Celgene Patient Support can provide information about financial assistance for transportation costs to and from medical appointments. Independent third-party organizations may be able to help patients with transportation costs, such as gasoline, parking, tolls, and taxi, bus, or train fare, to and from medical appointments. Financial and medical eligibility requirements vary.
Eligibility criteria for participation in the Celgene Commercial Co-pay Program include:
- Commercial or private insurance that does not cover the full cost of the prescribed Celgene medication
- Residence in the United States or a US territory
- Patients with government healthcare insurance, including Medicaid, Medicare, Medigap, TriCare, and CHAMPVA, are not eligible
- Other eligibility requirements and restrictions apply; full “terms and conditions” are available at CelgenePatientSupport.com.
At the request of the patient, Celgene specialists are available to assist with each step in the insurance approval process for prescribed Celgene medications. Celgene cannot provide insurance advice or make insurance decisions. These specialists will help with the following steps.
- Initiate a benefits investigation to determine copayment and other out-of-pocket costs
- Assess prior authorization or precertification requirements
- Educate patients about insurance coverage or other programs for which they may qualify.
Prior Authorization/Precertification Assistance
- Assist with the prior authorization or precertification process by providing the necessary forms for completion
- Follow up with the insurance provider to determine the outcome
- Celgene provides a facilitation service and will not provide any medical input into a prior authorization.
- Provide information about the appeals process after a denied prior authorization, precertification, and/or claim
- Supply a checklist of the required documentation for submission to the insurance company
- Submit the appeal to the insurance company at the request of the patient and follow up on the status until a decision is reached
- Celgene provides a facilitation service and will not provide any medical input into an appeal.
Enrollment & Application
Celgene offers 3 simple ways for patients to enroll in Celgene Patient Support. Patients should choose the way that is easiest for them:
- Enroll online at CelgenePatientSupport.com
- Call 800-931-8691
Patients can be enrolled over the phone (at 800-931-8691), Monday-Thursday, 8 am-7 pm ET; Friday, 8 am-6 pm ET (translation services available)
- E-mail or fax the enrollment form
Download the English or Spanish enrollment form at CelgenePatientSupport.com and return it by e-mail to PatientSupport@celgene.com or fax it to 800-822-2496.