There are a number of government programs in place that may be available to you. However, eligibility requirements and restrictions vary for each. The NS Support team can help you navigate the following:

Medicaid is the single largest source of health insurance for children in the United States. It is administered by state governments with both state and federal funding.

Medicaid Waiver Programs allow the state Medicaid service to waive the rules that usually apply to the Medicaid program. There are three types of waivers within the program and your Patient Engagement Lead may share the difference between the waiver programs so that you can determine which one is appropriate for you.

Children’s Health Insurance Program (CHIP) provides free or low-cost health insurance for a child whose family’s income is too high to qualify for Medicaid.

Supplemental Security Income (SSI) is a federal program that provides monthly payments to children younger than 18 years of age with physical or mental disabilities.

Dual-eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan specifically for patients who are eligible for both Medicare and Medicaid.

Coverage varies by health plan. We can help inform you of your insurance coverage by contacting your insurer to obtain benefits for your specific plan. Please work with your physician to complete, sign, and submit the Patient Enrollment Form, and then we can get started.

NS Support can verify your Medicaid coverage and can share detailed information with you and your physician. First, you just need to complete and submit a Patient Enrollment Form.

The NS Support Co-pay Assistance Program covers out-of-pocket costs for commercially insured patients who meet the eligibility requirements. Out-of-pocket costs include the deductible, co-pay, and co-insurance for the medication.

• Patient must be a citizen or a permanent resident of the United States or its territories and reside in the United States or its territories where co-pay assistance is not prohibited. Offer good only in the United States and its territories.
• Patient must not be covered, in whole or in part, by government health insurance (including Medicare, Medicaid, Indian Health Service, Department of Defense, or other federal or state assistance programs). If patient moves or switches from commercial insurance to any government health insurance, patient will no longer be eligible.
• This program is not valid in states where prohibited by law, taxed, or otherwise restricted.
• Patient is being treated by a licensed healthcare provider in the United States and has been prescribed a product by a licensed healthcare provider.
• Patient currently has private, commercial health insurance with prescription coverage for the medication, and patient’s insurance does not cover the entire cost of the product.

If a patient becomes ineligible under the Program (for example, obtaining government-funded health insurance), the patient will no longer be eligible for Program benefits.

Yes, patients who are insured through the Health Care Exchange and otherwise meet the Program eligibility requirements will be eligible for the NS Support Co-pay Assistance Program because this is private insurance, not a public payer like Medicaid.

There are some organizations that may be able to assist you—from foundations working to make treatment more affordable to advocacy groups. Once you enroll in NS Support, a Patient Engagement Lead from the NS Support team can help you find out more.