Part D Assistance Program

What is PDAP?
What are the Medicare requirements of PDAP?
Who is eligible for the program?
What documentation is required?
What is the enrollment process?
Is there a need for re-enrollment?

What is PDAP?

Renassist is pleased to announce that the Renvela® Medicare Part D Assistance Program will open on January 1, 2012. The 2012 Renassist Insurance Verification From and Patient Assistance Application will be available at that time.

Genzyme’s Renvela Medicare Part D Assistance Program (PDAP) provides a free supply of Renvela^® (sevelamer carbonate) to eligible Medicare Part D patients who cannot afford their co-payments or co-insurance for Renvela.

• Refills must be requested by the Health Care Professional.
• Hectorol is not offered through this program.
• If less than 3-months remain in the year, the patient will receive enough medication to last until December 31st.

What are the Medicare requirements of PDAP?

• A patient may not submit any claim for compensation or reimbursement for Renvela to any third party including a Medicare Part D plan or another public or private plan or program while the patient is receiving free Renvela from Genzyme’s Renvela Medicare Part D Program.
• The cost of this drug will NOT accumulate towards the patient’s True Out of Pocket (TrOOP).

Who is eligible for the program?

• Eligible applicants must be enrolled in a Medicare Part D Plan or MA-PD Plan and must not have any other prescription drug coverage for Renvela®.
• Applicants who earn up to 300% of the Federal Poverty Level (FPL) are eligible.
• Applicants below 150% of the FPL must show proof of LIS denial.
• $1000 Total Household Rx out of pocket required.
  • Proof of out of pocket required (Explanation of Benefits (EOB) or pharmacy print out).

What documentation is required?

• A Renassist Insurance Verification Form & Patient Assistance Application* must be completed and submitted to Renassist^SM via fax or email to 877-363-6732 or pap@genzyme.com.
• A prescription signed by a prescriber must be completed on the application.
• Proof of total household Rx out of pocket (Explanation of Benefits (EOB) or pharmacy print out).
• For those patients below 150% of the Federal Poverty Level (FPL) but who are not eligible for the Medicare Part D Limited Income Subsidy (LIS):
  • The application must be accompanied by a Notice of Denial or Pre-Decisional Notice for LIS from the Social Security Administration.

What is the enrollment process?

• Renassist Insurance Verification Form & Patient Assistance Application* is submitted to Genzyme via fax or email at 877-363-6732 or pap@genzyme.com.
• You and/or your patient will be contacted by fax or phone if an application is incomplete or requires additional information.
• A Renassist Case Manager will contact you regarding approval or denial.
• Diplomat Specialty Pharmacy will ship up to a 3-month supply of free drug to the location identified on the application.
• Qualifying patients will receive free drug through the end of the calendar year in 3-month increments.
• Refills must be requested by the patient’s HCP.

Is there a need for re-enrollment?

• Applicants are required to re-apply on an annual basis.
• Genzyme’s Renvela Medicare Part D Assistance Program supplies free drug through December 31^st of the calendar year.
• New applications, along with any changes in criteria, are available on our forms & links page or by calling Renassist at 800-847-0069.

*If you do not have Adobe Reader version 9.0 or higher, be sure to save the application onto your desktop before electronically entering information to ensure that your work is captured and saved.