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Specialty Pharmacy

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Financial Support and Understanding Insurance

Financial Support

We know that specialty medicines can cost a lot, even with insurance. If you cannot afford your medicines, we can find ways to help. We work with several programs that may be able to help pay for specialty medications.

Understanding Your Insurance

What These Insurance Words Mean:

  • Refill-too-soon: You are trying to get a refill sooner than your insurance company allows. Most insurance companies will let you get more medicine when you have used a certain amount. This is based on how long they think your supply should last. If your provider tells you to start taking your medicine differently, please let us know. If you need to leave town and will run out of medicine while you are gone, please let us know
  • Quantity Limits: Your provider wants you to take more medicine than your insurance will cover. This
    can be the number of tablets you take every day or how much medication you can get at a single time. We will explain what the limits are and answer any questions you have.
  • Step Therapy: Your insurance company wants you to try cheaper medicines before they will pay for a more
    expensive medicine.
  • Prior Authorization: Your insurance will not pay for your medicine unless they get information about why
    you need it. We will work with your provider’s office to send the insurance company what they require.
  • Copayment: This is the amount you have to pay every time you use a service that your insurance covers. The insurance company pays part of the cost and you pay part. There is usually a copayment every time you get medicine.
  • In-Network Pharmacy: A pharmacy that agrees to give lower prices to an insurance company’s

We can tell you how much more it will cost to use a pharmacy that is not in network. We can also let you know if your insurance company is limiting your medicine.

Finding Out What Your Insurance Will Pay

We can review your insurance plan to find what your insurance company will pay. Then, we can tell you about how much your treatment will cost. If you need access to old pharmacy claims information, we can give that to you for medications filled with our pharmacy. You can also call your insurance to ask for a copy of all of your old pharmacy claims.