Are you having problems trying to refill your pulmonary hypertension (PH) prescriptions? Enlist your care team to help you manage insurance issues.
Health insurance companies often control costs by limiting access to expensive care through prior authorization and step therapy.
Prior authorization means your care team needs approval from your insurance company before you can receive tests or treatment.
Step therapy means the insurance company wants you to try an often-cheaper medication or treatment before it covers therapy prescribed by your physician. You can repeal that requirement to immediately start the physician-prescribed treatment.
Need help navigating the process? Health care professional often are familiar with how to secure prior authorization and appeal step therapy. They also can help navigate the appeals process if the insurance company denies your claims.
Looking for additional information? The Pulmonary Hypertension Association (PHA)’s online insurance guide addresses a wide range of topics, including troubleshooting insurance problems. You also can contact PHA’s Treatment Access Program with questions about navigating insurance coverage. Call 301-565-3004 x758 or email us.
Thanks to Janssen Pharmaceuticals for its 2022 support of PHA’s Treatment Access Program.