Remicade
(infliximab)Remicade 100 MG Injection
Dosage & administration
drug label
Remicade prescribing information
prior authorization
Remicade prior authorization resources
Most recent Remicade prior authorization forms
View By PayerVerified: Dec 03, 2023Highmark BCBS Northeastern NY - Outpatient Infliximab Prior Authorization Form (Medical Benefit)
Verified: Dec 03, 2023Highmark BCBS Western NY - Outpatient Infliximab Prior Authorization Form (Medical Benefit)
Verified: Dec 02, 2023Highmark BCBS West Virginia - Outpatient Infliximab Prior Authorization Form (Medical Benefit)
Verified: Dec 02, 2023Highmark BCBS Delaware - Outpatient Infliximab Prior Authorization Form (Medical Benefit)
Verified: Dec 02, 2023Highmark BCBS Central PA - Outpatient Infliximab Prior Authorization Form (Medical Benefit)
Verified: Dec 01, 2023Highmark BCBS Western PA - Outpatient Infliximab Prior Authorization Form (Medical Benefit)
Verified: Dec 01, 2023Blue Cross Blue Shield of Michigan - FEP Infliximab Biosimilar Prior Authorization Form (Medical Benefit)
Verified: Nov 26, 2023Cigna - Infliximab Biosimilar Prior Authorization Form
Verified: Nov 25, 2023Blue Cross Blue Shield of Michigan - Infliximab Products Prior Authorization Form (Medical Benefit)
Verified: Nov 20, 2023Aetna - Remicade Prior Authorization Form
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If available, these templates are provided by the brand to help you navigate insurance, especially with newer drugs.
Benefits investigation
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Benefits investigations are conducted to determine whether a therapy is covered under a patient's insurance, if a prior authorization is required, and which specialty pharmacies are preferred.
financial assistance
Remicade financial assistance options
Co-pay savings program
commercial only
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Overview
- Reduce patient OOP costs for drug (and occasionally for drug administration/infusion costs or drug-related test costs)
Patient benefit
- A portion (or all) of patient OOP (deductible, copay), typically up to monthly and/or annual max
Patient eligibility
- Patient must enroll or activate (may permit HCPs to enroll on patient’s behalf for HCP-administered drugs)
- Generally, must have commercial insurance (rarely, may permit uninsured patients to use)
- May never be used with government insurance
How to sign up
- Cards may be downloadable digital cards or hard copies
- Some pharmacos offer debit cards with pre-loaded copay benefit
- Typically, available through multiple channels (e.g., rep to HCP to patient; pharmacy to patient; patient via website, Hub live agent, or copay vendor (live agent or IVR); patient and HCP via Hub enrollment form)
- Some HCP-administered product programs permit HCPs to enroll on a patient’s behalf through via Hub form
Foundation programs
under insured
no insurance
goverment insurance
65+
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Overview
- Charitable 501(c)(3) organizations provide direct cost-sharing and other support (e.g., travel, counseling) through disease-state funds to indigent patients on first-come first-served basis
- These organizations may receive financial contributions from drug manaufacturers for particular disease-state funds that cannot provide funds directly to patients - the foundation must be independent/unaligned
Patient benefit
- Patients apply for grants that cover a portion (or all) of their out-of-pocket costs (deductibles and co-pays) until the grant is exhausted
Patient eligibility
- Patients must apply and meet eligibility criteria including income level (typically a multiple of federal poverty line), specific diagnosis, insurance status, etc.
How to sign up
- Patients submit proof of out-of-pocket drug costs to charities for reimbursement
patient education
Remicade patient education
To share resource; ask patient to:
1.Pull out phone
2.Open camera
3.Scan QR code with camera
4.Tap link
Patient toolkit
About Remicade: Pediatric Crohn's Disease
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
About Remicade: Pediatric Ulcerative Colitis
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
Receiving Remicade: Pediatric Crohn's Disease
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
Receiving Remicade: Pediatric Ulcerative Colitis
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link
Receiving Remicade: Ankylosing Spondylitis
ASK PATIENT TO:
Open Camera on Phone
Scan QR Code & Tap Link
Open Camera on Phone
Scan QR Code & Tap Link