When HealthWell approves a grant, we will send the patient a Reimbursement Request Form with the approval letter. The patient, health care provider, pharmacy, or social worker must submit a Reimbursement Request Form along with supporting documentation each time the patient has an eligible out-of-pocket expense. All the details for submission are included on the form.
For most individual funds, reimbursement requests that are less than $5.00 will not be reviewed or considered for payment. 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.
If your patient has been approved for premium assistance through HealthWell, they will receive an approval letter with instructions on how to use their grant along with a Premium Reimbursement Request form. Your patient can submit their reimbursement request through our Patient Portal or fax it to (800) 282-7692.
HealthWell Pharmacy Card
For some disease funds, we are able to send patients a HealthWell Pharmacy Card with their approval letter. Patients should bring the HealthWell Pharmacy Card to the pharmacy when they fill their prescriptions, or call their specialty or mail order pharmacy and provide the numbers on the card. The card is similar to an insurance card and the pharmacist should be able to use it to pay the copayment for eligible treatments. HealthWell is the payer of last resort and we require the Coordination of Benefits (COB) code 8 to ensure the patient’s grant is accessed appropriately. As all our grants are capped, once that capped amount is reached, the patient cannot get more money until they re-enroll for the next calendar year. By running the HealthWell card first, you run the risk of burning through the patient’s grant prematurely. Without our assistance, the patient may have to stop therapy altogether.
HealthWell’s Real-Time Pharmacy Card Lookup Tool is available to all pharmacy partners. This secure tool provides quick access to Pharmacy Card information for your patients with active grants.
- For patients with a HealthWell Pharmacy Card, you would run the claim through ALL OTHER INSURANCES FIRST, then run the claim using the HealthWell card.
- HealthWell will only process eligible payment requests of the fund’s minimum reimbursement amount or higher.
- In order for patient grants to remain active, we must receive the first complete reimbursement request within 120 days of the date on their approval letter, and continue to receive a complete reimbursement request at least every 120 days. After 120 days of inactivity on the grant (i.e., no payment activity), it 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.
- Once we receive a complete reimbursement request, you should receive a reimbursement check in approximately two weeks.