Next Steps

After pre-approval via phone or online, we will send the patient a pre-approval letter and there is still ACTION REQUIRED. The letter outlines the documentation we require and will include a blank Statement of Treatment for the provider to complete. In addition, if the patient provides us with the name and fax number for the provider contact, we will fax the Statement of Treatment with cover sheet to the provider’s office. 

NOTE: this is the only notification sent regarding the required documentation to both the patient and provider. It is the responsibility of the patient and provider to ensure we received the required documentation within 30 days of the approval.
 

When a Patient is Approved
 

Once we have received the required documentation, we will send the patient an approval letter titled "APPROVED." This letter will provide the patient with a Reimbursement Request Form (RRF) and instructions for submitting for reimbursement OR a pharmacy card (fund appropriate).  In addition, we will fax a copy of the approval letter to the provider.

Patients or their providers may then submit invoices or receipts to receive reimbursement for their prescription treatments for this disease according to the instructions outlined on the RRF.  The Foundation typically sends awards directly to the insurer, pharmacy, physician, or other provider. However, it may reimburse patients directly if they must pay for the expenses themselves.

In some cases, patients may receive a HealthWell pharmacy card that they can take to their pharmacy when they fill their prescription.  Most pharmacies accept the card to pay the patient's copyament at the time of dispensing.  The HealthWell pharmacy card also works with most mail order or specialty pharmacies.  If your pharmacist has questions about using the HealthWell pharmacy card, please ask him or her to call the pharmacist number on the front of the card. 

The HealthWell Foundation does not restrict the medications that patients use as long as the medication is approved by the Food and Drug Administration and is being used to treat a condition that falls within a funded area.  However, we do focus on helping patients with extreme treatment costs and therefore typically do not reimburse for very low-cost treatments, such as generics and steroids.  When these lower cost treatments represent a financial hardship to a particular patient, they may be reimbursed on an exception basis.

The Foundation also does not restrict the provider or pharmacy that the patient selects, and patients are free to change providers or pharmacies at any time. 

The HealthWell Foundation reserves the right to change its program in its entirety or with respect to any applicant at any time with or without notice.