Insurance Information

There are many continuing changes within health insurance today. Even with a great insurance policy, always be sure to understand your coverage. The Hemophilia Center of WNY stresses the importance of knowing every aspect of your insurance policy coverage and regulations, as they are varied.

Many insurance plans now require a preauthorization and/or pre-certification for hemophilia services. Preauthorization equals permission to receive certain outpatient services. Pre-certification equals medical necessity for a requested service (i.e. factor).

Understand the difference between these terms:

  • Deductible – a fixed dollar amount you must pay before your plan begins to pay.
  • Co-payments – a set amount you pay each time you have a hemophilia related service (some insurances are taking a co-pay on factor now).
  • Coinsurance – percentage of the cost of your care for which you are responsible (for example 80/20 -  the Center receives the 80% from the insurance company and you pay the 20%). Some policies, however, are as high as 50/50, which could result in your responsibility for thousands of dollars.

It is very important to know which of the above apply to your individual policies.

Most pharmaceutical companies offer patient assistance programs designed to ensure that our patients are able to continue to receive their medication even if they lose their health insurance coverage or are underinsured and cannot afford their co-pays or coinsurance on their medication (i.e. free trial programs, co-pay assistance programs, free factor programs, etc.).

If you are interested in any of the above patient assistance programs, are experiencing a current issue with your health insurance, or are expecting an impending change in your insurance, please contact us at (716) 218-4007 for assistance.

If you have a specific question regarding your insurance policy, please contact our Senior Biller at (716) 218-4014.

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