As a patient, once you are approved, there are four ways for you to access your grant:
- Use the HealthWell Pharmacy Card (Note: Not all funds offer the Pharmacy Card);
- For premium payments, upon receipt of the needed information, we will set up payments to go automatically and directly to your insurer;
- Pay up front and submit to HealthWell for direct reimbursement; or
- Ask your provider’s office or pharmacy to direct bill with HealthWell (there is no registration necessary for this and no cost to the office or pharmacy to direct bill with us).
The good news is most provider offices and pharmacies are happy to direct bill with HealthWell and take care of this on your behalf.
Tips on Accessing the Grant
Using the HealthWell Pharmacy Card
- Bring the HealthWell Pharmacy Card to the pharmacy when you fill your prescriptions, or call your specialty or mail order pharmacy and provide the numbers on the card.
- If you know you are approved, but have not received your Pharmacy Card in the mail yet, you or your pharmacist can use the Pharmacy Card Lookup Tool to obtain all the necessary information to run your claim.
- If the pharmacist has questions about how to use the HealthWell Pharmacy Card, he or she should call the pharmacist telephone number on the back of the card.
- Make sure the pharmacist runs ALL OTHER INSURANCE and PRESCRIPTION cards FIRST before running your HealthWell Pharmacy Card.
Provider or Pharmacy Direct Billing with HealthWell
When HealthWell approves a grant for copayment assistance, we will send you a Reimbursement Request Form with the approval letter. We will copy your provider on the letter that also includes this form. You can give your copy to your pharmacy or the pharmacist can download a copy from our website.
Your pharmacy or provider must submit a Reimbursement Request Form along with complete supporting documentation each time you have an out-of-pocket treatment expense.
Paying Up Front and Submitting to HealthWell
Once you are approved in a fund, we can begin reimbursing for dates of service and prescription fill dates back to the grant start date. If you have paid your out-of-pocket costs already, we can reimburse you directly with the appropriate documentation.
Complete the Reimbursement Request Form and submit it with all required documentation to us for review. The form outlines all the requirement details.
Insurance Premium Payment
Once you are approved in a fund, we can work with you to send premium payments directly to your insurer on your behalf or reimburse you for premium payments you may have already paid.
Either way, you need to complete the Premium Reimbursement Request Form and submit it with all required documentation to us for review. The form outlines all the requirement details.
Minimum Reimbursement Amount
HealthWell has always had a minimum dollar requirement in place for reimbursement requests. For most HealthWell funds, the minimum reimbursement amount is $5.00. However, HealthWell allows for reimbursement requests to be combined, and if the combined amount of the requests meets or exceeds $5 (or the applicable minimum reimbursement amount) then such combined amount may be eligible for reimbursement.
What This Means for Our Grant Recipients
HealthWell will only process eligible payment requests of the fund’s minimum reimbursement amount or higher. For most funds, the minimum reimbursement amount is $5.00 so payment requests for less than $5.00 will not be reimbursed. This includes both prescriptions filled through the HealthWell Pharmacy Card and those sent to HealthWell for processing.
Notes on all Grants
- HealthWell is the payer of last resort and all our grants are capped. We cannot add to the grant once that capped amount is reached. With re-enrollment, you will receive a new grant to assist with your out-of-pocket costs.
- Please submit your claims as soon as possible. We must receive a claim at least once every 120 days or the grant will close. If the grant closes, the patient, provider, or pharmacist may still submit eligible payments requests, however, we cannot guarantee funding will be available and payment made.
- HealthWell kindly asks that payment requests be submitted to us within 120 days from the date of service. After 120 days, HealthWell will consider payment on a case-by-case basis depending on circumstances relative to the delay. Please contact the hotline at (800) 675-8416 to obtain a Timely Filing Form and instructions on submitting it to HealthWell for consideration.