The Patient Access Line

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Your Patient Access Roadmap

Answer a few questions and we'll guide you to the resources, tools, and next steps that may help you navigate treatment access.

Let's Find Your Best Next Step

Every patient's journey is different. Whether you're waiting for approval, dealing with a denial, struggling with costs, or transitioning insurance, we'll help point you to resources that may help.

This tool provides educational guidance only and does not provide medical, legal, or insurance advice.

Access Roadmaps

What Do I Do Next?

Patient-friendly, step-by-step paths for the most common access situations.

Roadmap 1

My Prior Authorization Was Denied

  1. 1

    Read the denial letter and note the stated reason

  2. 2

    Call your insurer to confirm the denial code and appeal window

  3. 3

    Ask your prescriber's office to file a provider appeal

  4. 4

    Gather supporting documents (chart notes, prior therapies)

  5. 5

    Submit a patient appeal if needed and request peer-to-peer review

Roadmap 2

My Medication Costs Too Much

  1. 1

    Check the manufacturer copay card for your medication

  2. 2

    Apply for a patient assistance program (PAP) if uninsured/underinsured

  3. 3

    Explore foundation grants (PAN, HealthWell, Good Days)

  4. 4

    Ask about a 30-day bridge supply from the manufacturer

  5. 5

    Talk to your pharmacist about specialty pharmacy options

Roadmap 3

I'm Starting Medicare

  1. 1

    Choose a Part D plan that covers your medications

  2. 2

    Review the out-of-pocket cap and the Prescription Payment Plan

  3. 3

    Confirm your specialty pharmacy is in-network

  4. 4

    Check Medicare-eligible foundation grants

  5. 5

    Set calendar reminders for re-enrollment windows

Roadmap 4

My Insurance Changed

  1. 1

    Confirm your medication is on the new formulary

  2. 2

    Request a new prior authorization if required

  3. 3

    Update your specialty pharmacy and prescriber

  4. 4

    Re-enroll in copay assistance under the new plan

  5. 5

    Ask about transition fills to prevent gaps

Roadmap 5

I Can't Afford My Deductible

  1. 1

    Apply manufacturer copay assistance to deductible costs

  2. 2

    Look for foundation grants that cover deductibles

  3. 3

    Ask about extended payment plans through your pharmacy

  4. 4

    Confirm whether your plan has an accumulator or maximizer

  5. 5

    Plan refills strategically around plan-year resets