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Benefits Investigation Support
Each payer is unique and insurance benefits can vary. Feraheme Assist has the skill to help navigate the prescription approval process for patients who need FERAHEME therapy. A Care Manager will complete the benefits investigation, support the prior authorization process (when applicable), and offer help if you need to appeal a denial.
Use this letter as a template if a health plan denies FERAHEME coverage
Download Clinical Consideration support material for Prior Authorizations and Appeals
After confirming coverage, a Care Manager will proactively provide plan-specific requirements for your patient and can offer information on FERAHEME coding and billing, if needed.
Patient Assistance Program
AMAG Pharmaceuticals is committed to helping patients access their FERAHEME treatment. Eligible uninsured and commercially underinsured patients may receive a single course of therapy at no cost.* To assess eligibility, complete Step 6 on the enrollment form and submit to Feraheme Assist.
Find the Feraheme Assist patient certification and income verification form required for participation in the Patient Assistance Program
*Each patient’s eligibility is evaluated on an individual basis. To be eligible, patients must meet the FDA-approved indication for FERAHEME. In compliance with federal regulations, patients insured by a government-funded program (Medicaid, Medicare, TRICARE, etc) are not eligible. Patient must be at or below 500% federal poverty level based on residency to participate. This program may be discontinued or modified at any time based on eligibility, state and local laws, and program availability. For full program eligibility, restrictions, and enrollment requirements, please contact Feraheme Assist.
To get started, connect with Feraheme Assist
Submit a completed enrollment form to Feraheme Assist via fax (877-591-2505)
- Include a copy of both sides of the patient insurance card(s)
- If your patient is uninsured or commercially underinsured, complete Step 6 of the enrollment form to have your patient evaluated for participation in the Patient Assistance Program
- Ensure both you and your patient have signed the form
- If needed, patients can sign a stand-alone authorization at www.allcareconsent.com
Upon receipt of the Feraheme Assist Enrollment Form:
- You will receive a fax confirming receipt of the enrollment form
- You will receive a detailed summary of your patient’s benefits once coverage is verified
FERAHEME has favorable non-restricted commercial coverage
According to the Hospital Outpatient Prospective Payment System (HOPPS) 2020 final fee schedule, FERAHEME was granted the status indicator “K,” which means it has its own Ambulatory Payment Classification (APC).
For more information, please visit the Centers for Medicare & Medicaid Services website at https://www.cms.gov/Medicare/Medicare.html.