One of the most important aspects of taking an oncology/hematology medication is determining your insurance coverage, navigating your options, and making medication affordable. Our Patient Advocates will guide you through this process.
Prior Authorization (PA)
A Prior Authorization (PA) may be required by your insurance company to verify the prescribed medication is appropriate for your specific diagnosis. Review and approval of prior authorizations take 3-5 business days and is required for the insurance to pay their covered amount of medication cost.
Medicare Part D Coverage Gap (Donut Hole)
For information on Medicare Part D plans, types of coverage, and enrollment go to https://www.medicare.gov/part-d/index.html
The Medicare Part D Coverage Gap, also referred to as the “Donut Hole,” is the amount between initial insurance coverage and catastrophic coverage amount. Higher out-of-pocket cost are incurred until the catastrophic coverage threshold is reached. Financial assistance may be available through non-profit foundation programs to help cover these out of pocket cost. For more detailed information regarding the Medicare Part D Coverage Gap go to
For information and eligibility criteria of foundation programs, click on the links below
Other resources such as drug manufacturer copay card and Patient Assistance Programs (PAP) may be available to help in covering the cost of your medication.
Call toll free (877) 986-2046, option 3, to talk with a patient advocate.