Once a patient is fully approved in a fund, we can begin reimbursing for dates of service and prescription fill dates back to the grant start date (up to 30 days prior to the pre-approval date).
For patients who do not receive a HealthWell pharmacy card, you have the option of direct billing with HealthWell. This is helpful for many patients who cannot pay up front and wait for reimbursement. To direct bill with us, you simply complete a Reimbursement Request Form and submit it with the documentation as outlined on the form.
Please keep in mind we must receive a payable reimbursement request at least every 90 days to keep the patient’s grant open. If there is no payable reimbursement request for 90 days, the grant will close. If the grant closes, you or the patient may still submit for payment and we will do our best to process payment based on available funding.
Also, HealthWell may not reimburse any claim once the date of service or prescription fill date has passed 120 days.
Minimum Reimbursement Amount
HealthWell has always had a minimum dollar requirement in place for reimbursement requests. For most HealthWell funds, the minimum reimbursement amount is $25.00. This will be applied to each prescription fill or individual charge.
What This Means for Our Grant Recipients
HealthWell will only process eligible payment requests of the fund's minimum reimbursement amount or higher. For most funds, the minimum reimbursement amount is $25.00 so payment requests for less than $25.00 will not be reimbursed. This includes both prescriptions filled through the HealthWell pharmacy card and those sent to HealthWell for processing.
Charges must be itemized, they cannot be combined. For example, when the fund's minimum reimbursement amount is $25.00, if a pharmacy fills three prescriptions on the same day and each is for $10.00, the three charges cannot be combined to meet the $25.00 minimum.