Will my insurance cover my Increlex prescription?

We cannot say whether your insurance will cover as this is a new product. What we can do is take your insurance information and determine what benefits you have for self injectables such as Increlex. Once your physician completes the Increlex SMN along with your signed patient consent and authorization form, then we can submit for a prior authorization which will determine if your insurance will cover Increlex therapy.

What is a prior authorization?

A prior authorization is when your insurance company must pre-approve your medication before you start reimbursed therapy. This normally involves providing them medical information so that they can understand why your physician wants you to start this treatment.

What will I do if my insurance does not cover my prescription?

If your insurance does not cover Increlex then we can help you appeal that decision. If they uphold their decision after the appeal process has been exhausted, TerciCare will investigate alternative sources of reimbursement.

Is Medicaid covering Increlex?

Increlex is a new product and may take some time for the various Medicaids to get this listed in their databases. In the meantime what we can do is once the product is available we can work with your specific Medicaid to determine if they will pay for it.

Do you know what my copay would be if I started Increlex?

We can't say without calling your insurance to determine your benefits. Please be aware that we can determine your potential co-payment but this is not a guarantee of payment as we expect that insurances will require a prior authorization for the product.

Do you have an uninsured program?

Yes we do have a program to help uninsured patients get access to Increlex. Please call TerciCare at 1-866-TERCICA (1-866-837-2422) and press option #3 to speak to a case manager.

Will you have a Starter prescription or program?

Yes, we do offer a Starter program. Please call TerciCare at 1-866-TERCICA (1-866-837-2422) and press option #3 to speak to a case manager.

How can the TerciCare program help me?

TerciCare staff are available to assist with reimbursement. Once a physician decides to prescribe Increlex then they would send the Increlex SMN along with your signed patient consent and authorization form to TerciCare who will then check your benefits and refer your file to the most appropriate specialty distributor. TerciCare helps answer any reimbursement question and also provides appeal assistance if Increlex is denied.

How long does it take to obtain insurance coverage for Increlex?

This varies by insurance plan and can be as fast as 48 hrs or as long as 90 days.

Email the Increlex website to a friend       Print this page