- Over 54,000 patients assisted in 2010.
- 21,000 callers assisted each month.
- $144 million+ awarded to patients in 2010.
- Over 150,000 patients helped to date.
FAQs for Providers
- How do I apply on behalf of my patients?
- Do you cover the entire copayment or just certain treatments?
- How do I get reimbursed? What do I submit? Will I receive a check?
- My patient received a plastic HealthWell pharmacy card with his or her enrollment letter. How is it used?
- Are approvals retroactive?
- How do I check the status of my grant?
- How do I check the status of my payment?
- How long do I have to submit a claim for reimbursement?
Important Documents
Statement of TreatmentTerms and Conditions
Reimbursement Request Form
Understanding Payment Denials
Tips for Working Efficiently with HealthWell
How do I apply on behalf of my patients?
The easiest and fastest way to apply is to complete the application online. If you do not have access to a computer, you can call with the patient on the line to apply (800) 675-8416.
If pre-approved, submit the following required documentation within 30 days:
- Complete Statement of Treatment with the prescribing provider’s signature
- A copy of the patients insurance and pharmacy card(s) – front and back.
- If requesting premium assistance, also include:
- Documentation from your insurer or employer confirming the portion of the health insurance premium you are responsible for paying
- Documentation that your insurance will cover the medications for the disease state. You may submit any of the following:
- Letter from insurer, or
- Explanation of Benefits (EOB) form (must include patient name, insurer name, drug name and copay amount), or
- Recent pharmacy receipt (must include patient name, insurer name, drug name and copay amount)
We must receive ALL the required documentation within 30 days of approval or the grant will close and the patient cannot re-apply for a grant until the next calendar year.
NOTE: we will not call or send letters requesting any missing required documentation. It is the responsibility of the patient and provider to ensure we received the required documentation within 30 days of the pre-approval.
For fastest service, please fax these items to us at (800) 282-7692. If you do not have access to a fax machine, you may mail these materials to: HealthWell Foundation, P.O. Box 4133, Gaithersburg, MD 20878.
Do you cover the entire copayment or just certain treatments?
The Foundation pays only copayments related to prescription treatments taken specifically for the medical condition listed in the application. The Foundation typically does not reimburse for lower cost treatments, such as steroids, pain medication, and generic medicines. Please keep in mind that patients are free to change the type of medication they are taking or their provider at any time without affecting their eligibility.
How do I get reimbursed? What do I submit? Will I receive a check?
Upon receipt of the required documentation, the patient will receive a Reimbursement Request Form in the mail with the second approval letter. The patient must submit a Reimbursement Request Form, along with an invoice and proof of payment, each time he or she has an out-of-pocket cost for an eligible medication. If the patient has not yet paid the copayment or premium, the patient should indicate this on the Reimbursement Request Form, and we will mail the payment directly to the pharmacy, physician, or insurer. If the patient has already paid the premium or copayment, the Foundation will send the reimbursement check to him or her. Please note that the patient must include proof of payment with all reimbursement requests. Proof of payment includes a copy of a canceled check, a credit card receipt or statement, or an itemized receipt from the pharmacy or doctor listing the drug purchased. Many times we are able to coordinate billing with the pharmacy or physician. In these cases, we will send the award payment directly to them after the patient has received his or her medication. Please contact us to discuss a direct billing arrangement.
Depending on the disease fund a patient is enrolled in, he or she may also receive a HealthWell Pharmacy card with the enrollment letter. If so, please see the next question.
My patient received a plastic HealthWell pharmacy card with his or her enrollment letter. How is it used?
The patient should bring the HealthWell pharmacy card to the pharmacy when filling his or her prescription, or call the mail order pharmacy and provide the numbers on the card. The card is similar to an insurance card and the pharmacist should be able to use it to pay the copayment for the treatment. If the pharmacist has questions about how to use the HealthWell card, he or she may call the pharmacist telephone number on the back of the card.
The patient cannot use the pharmacy card for treatments received at a doctor’s office. Instead, the physician must fill out a Reimbursement Request Form, which was received with the patient’s enrollment letter, and mail it to HealthWell with an invoice that shows the cost of the treatment.
Are approvals retroactive?
If approved, the patient grant is held the day of the call or online pre-approval. Eligible Dates of Service (DOS) for reimbursement start the day of the call or online approval. NOTE: We are no longer offering 90 day retroactive reimbursement.
How do I check the status of a grant?
You can check the status of a grant any time by using our automated telephone menu system at (800) 675-8416.
How do I check the status of my payment?
You should receive your reimbursement check about 2 to 3 weeks after we receive a complete payment request. If you have waited longer than this, please call us at (800) 675-8416.
How long do I have to submit a claim for reimbursement?
HealthWell will reimburse for dates of service beginning the date of approval and after, however:
- Payable claims must be received at HealthWell no more than 120 days after the date of service.
- Claims received after April 30 for the previous enrollment year will not be paid.
- To remain eligible for assistance, HealthWell must receive a reimbursement request within 60 days of the enrollment start date and continue to receive requests at least every 60 days or the grant will close and the patient cannot re-apply for a grant until the next calendar year.
Other questions? Please contact us.