Unlocking Coverage: Navigating Insurance Billing For Nucala Prescriptions

Nucala is a prescription medicine used to treat severe asthma and hypereosinophilic syndrome. It is not covered by most insurance plans, and the cost varies depending on the individual plan. To bill Nucala to insurance, patients can use the Gateway to Nucala program, which helps to understand the insurance company's policies for covering Nucala and estimate the out-of-pocket cost. Patients can also apply for the Nucala Copay Program, which helps eligible commercially insured patients with their out-of-pocket costs. Alternatively, patients can contact their insurance company directly to understand their policies and ask for an estimated cost. It is important for patients to understand their insurance coverage and any potential out-of-pocket expenses before starting treatment with Nucala.

The cost of Nucala varies depending on your insurance plan

The Gateway to Nucala program can help you understand your insurance company's policies for covering Nucala and estimate your out-of-pocket costs. However, it is important to note that the information provided by Gateway to Nucala is not a guarantee of coverage.

If you are uninsured and meet certain eligibility requirements, you may qualify for the Patient Assistance Program, which offers free medicine to eligible patients. Patients with Medicare Part D or other insurance plans may also qualify under certain circumstances.

To investigate the cost and coverage of Nucala, you can follow these steps:

• Discuss Nucala with your doctor.
• Use Gateway to Nucala to understand your insurance company's policies and estimate your costs.
• Fill out the Patient Section of the Enrollment Form and have your doctor complete and sign the Prescriber Sections.
• Fax the completed Enrollment Form to Gateway to Nucala.
• Wait to receive your benefits information in the mail, which will outline your insurance company's policies and estimate your out-of-pocket costs.

If you have any questions during this process, you can call the Gateway to Nucala representative line for assistance. Alternatively, you can contact your insurance company directly to understand their policies and request an estimated cost.

The Nucala Copay Program helps eligible patients with out-of-pocket costs

The Nucala Copay Program is designed to help eligible patients with their out-of-pocket costs for Nucala. To be eligible, patients must have a commercial medical or prescription insurance plan, be a resident of the US, and not be enrolled in a government-funded program. The program is open to all eligible patients, even if they don't use Gateway to Nucala.

The program helps patients with their eligible out-of-pocket costs for Nucala, with a maximum amount available of $9,450 annually for most patients.

To apply, patients can sign up online at www.NUCALACopayProgram.com or through their doctor via Gateway to Nucala. Once approved, patients will receive an approval email with specific instructions on how to save on the out-of-pocket cost for Nucala.

The Nucala Copay Program can be used at a specialty pharmacy or a doctor's office, depending on where the patient receives their Nucala treatment.

For those without prescription coverage who need help paying for their medicines, patients can call 1-844-4-NUCALA (1-844-468-2252).

Uninsured patients may qualify for the Patient Assistance Program

Uninsured patients who meet certain eligibility requirements may qualify for the Nucala Patient Assistance Program. This program offers eligible patients free access to Nucala.

To apply for the Nucala Patient Assistance Program, you must first discuss Nucala with your doctor. Then, you can fill out the Nucala Patient Assistance Program section of the Enrollment Form, which is available in Spanish, and sign it. Your doctor will also need to fill out and sign the Prescriber Sections of the form. The signatures on the form give GlaxoSmithKline (GSK) permission to ask your insurance company about your coverage.

After this, your doctor will need to fax the form to GSK at 1-844-237-3172. You will then receive your benefits information in the mail. This will outline your insurance company's policies for covering Nucala and estimate your out-of-pocket cost for the medicine. If you have any questions about this information, you can call 1-844-4-NUCALA (1-844-468-2252) or your insurance company.

If you have any questions at any point during the application process, you can call 1-844-4-NUCALA (1-844-468-2252) to speak to a representative. Representatives are available Monday through Friday, 8 AM to 8 PM ET.

It is important to note that information provided by Gateway to NUCALA is not a guarantee of coverage.

Patients with Medicare Part D or other insurance may also qualify for the Patient Assistance Program

To apply for the Patient Assistance Program, you must first discuss NUCALA with your doctor. You can then fill out the Patient Section of the Enrollment Form and have your doctor fill out the Prescriber Sections. The signatures on the form give permission for the insurance company to be asked about your coverage. You can then have your doctor fax the form to 1-844-237-3172.

Your benefits information will be sent to you in the mail. This will include your insurance company's policies for covering NUCALA and an estimate of your out-of-pocket cost for NUCALA. If you have any questions about this information, you can call 1-844-4-NUCALA (1-844-468-2252) or your insurance company.

If you have any questions at any point in this process, you can call 1-844-4-NUCALA (1-844-468-2252) to talk to a representative. Representatives are available Monday–Friday, 8 AM–8 PM ET.

Specialty pharmacies are used to ship Nucala directly to your home

Specialty pharmacies are different from traditional pharmacies because they focus on certain diseases that require more specialized medications, like Nucala. If you take Nucala at home, a specialty pharmacy will be used to ship your medicine directly to your home.

If you receive Nucala in your doctor’s office, your doctor may or may not use a specialty pharmacy. To fill your prescription, your specialty pharmacy will work through the approval process directly with your insurance company. During this process, your specialty pharmacy will need to call you to discuss important information and collect your copay. If you don't return calls from the specialty pharmacy, this will delay your prescription.

Sometimes a specialty pharmacy may call from an unknown number, so check your voicemail for messages that refer to a “prescription” and be sure to call them back. Once you’ve paid your copay, Nucala will be shipped directly to you if you use Nucala at home, or it will be shipped directly to your doctor if you receive Nucala in your doctor’s office.

In some cases, your doctor may make arrangements for you to receive Nucala from your doctor’s office without using a specialty pharmacy. In those instances, you may need to pay your copay to the doctor rather than paying the specialty pharmacy. Be sure to ask your doctor what to expect.

Frequently asked questions