CABENUVA (cabotegravir 200 mg/mL; rilpivirine 300 mg/mL) EXTENDED-RELEASE INJECTABLE SUSPENSIONS: FREQUENTLY ASKED QUESTIONS (FAQs)

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If you don’t find the answers you’re looking for, call ViiVConnect at 1-844-588-3288 (toll free), Monday – Friday, 8 AM – 11 PM (ET) to speak with an Access Coordinator. Multilingual options available.

General Information

  • What is ViiVConnect?

    ViiVConnect is here to provide information on insurance coverage and financial support programs that may help patients get their prescribed ViiV Healthcare medicine.

  • What services does ViiVConnect provide?

    We have programs for eligible patients who are insured, underinsured, and uninsured. When providers enroll patients in ViiVConnect for prescribed CABENUVA, our Access Coordinators help with:

    • Benefit verification
    • Prior authorization support
    • Claim denials and appeals support
    • Coding and billing assistance
    • Patient Assistance Program for patients who qualify*
    • Patient Savings Programs*

     

    If patients have insurance, Access Coordinators can contact health insurance plans to find out what out-of-pocket costs will be for prescribed ViiV Healthcare medicine. If patients don’t have insurance or insurance doesn’t cover the full medication cost, Access Coordinators can determine program eligibility for the ViiV Healthcare Patient Assistance Program (PAP)* or help you find information on other insurance options and financial support programs.

    *Subject to eligibility, program terms and conditions. ViiVConnect programs do not constitute health insurance.

  • Is there a charge for ViiVConnect?

    No

  • What is the ViiVConnect Portal?

    The ViiVConnect Portal is centralized online tool for healthcare providers to verify benefits for prescribed ViiV Healthcare medications. Healthcare providers can enroll their practice on the ViiVConnect Portal to enroll patients electronically in ViiVConnect and to:

    • Minimize paperwork with electronic forms, electronic signature, and document upload
    • Obtain real-time information on enrolled patients’ coverage status and case history
    • Submit prior authorizations for ViiV Healthcare medicines
    • Chat with an Access Coordinator Monday – Friday, 8AM – 11PM (ET)

Health Insurance Coverage

  • How do healthcare providers initiate the benefit verification process for prescribed CABENUVA, and how long does it take?

    Healthcare providers should complete and sign the CABENUVA Enrollment Form with their patients, and submit the form via the ViiVConnect Portal or fax, and the benefit verification process will initiate automatically if the patient has insurance. Our goal is to provide benefit verification within 48 hours of receiving a completed enrollment form.

     

    ViiVConnect benefit verification for prescribed ViiV medicine will include information concerning benefit status, product coverage, prior authorization requirements, deductible types, and copay amounts.

    Enrollment in ViiVConnect is not required by patients or providers to access prescribed CABENUVA.

  • Can ViiVConnect assist if the health insurance plan is requiring prior authorization?

    When patients are enrolled in ViiVConnect, an Access Coordinator can provide guidance on prior authorization steps and let providers and patients know what additional information or documentation may be needed.

     

    When a PA request has been submitted, ViiVConnect may follow up with the patient’s health insurance plan until it’s resolved. If the PA request is denied, a dedicated Access Coordinator can contact the patient’s health insurance plan to find out whether the decision can be appealed or if any exceptions exist, and provide information on other insurance options or additional financial support programs that may be able to help.

  • How can patients stay on their current medicine if their health plan is changing, if they’re switching jobs, or if they’re moving to a different state?

    We cannot guarantee that a patient’s health insurance plan will maintain continuous insurance coverage for the ViiV Healthcare medicine prescribed.

     

    When patients are enrolled in ViiVConnect, an Access Coordinator can contact the health insurance plan to find out how changes to the plan might impact out-of-pocket costs for prescribed ViiV Healthcare medicine. If patients lose their health insurance, or if a plan no longer covers enough of the medicine to make it affordable, we can help find information on alternative health insurance plans and financial support programs that may be able to help. If a patient is moving out of state, we can contact current and future health insurance plans in both states to help with information on maintaining continuous access to the prescription.

PATIENT SAVINGS PROGRAMS

  • What are CABENUVA Patient Savings Programs?

    The CABENUVA Patient Savings Programs* are for eligible patients to assist with out-of-pocket costs for prescribed CABENUVA, including deductibles, copays, and coinsurance.

     

    Access Coordinators are here to answer any questions you may have about the Patient Savings Programs. Call 1-844-588-3288 (toll free) Monday – Friday, 8 AM – 11 PM (ET) to speak live with an Access Coordinator. Multilingual options available.

    NOTE: The CABENUVA Patient Savings Programs are not health insurance and are only available to residents of the United States and US territories. They are not for persons receiving sole or primary prescription drug benefits through a government-funded plan or program (i.e., Medicare or Medicaid).

    *Subject to eligibility, program terms and conditions.

  • Is there a fee to apply?

    No, there is no cost to apply or enroll for the CABENUVA Patient Savings Programs.

  • How can patients enroll in the CABENUVA Patient Savings Programs for prescribed medicine?

    To apply for the CABENUVA Patient Savings Programs and copay assistance for prescribed CABENUVA, patients must first be enrolled in ViiVConnect. Once patients are enrolled in ViiVConnect, an Access Coordinator can verify their eligibility and register eligible patients in the appropriate copay program.

    To enroll patients in ViiVConnect, healthcare providers can complete and sign the CABENUVA Enrollment Form with patients and submit the form via the ViiVConnect Portal or by fax.

  • Where can I find more information about copay savings for prescribed CABENUVA?

    Patients and providers can find more detailed information about the program on the CABENUVA Patient Savings Programs page or call 1-844-588-3288 (toll free) to speak live with an Access Coordinator, Monday – Friday, 8 AM – 11 PM (ET).

PATIENT ASSISTANCE PROGRAM (PAP)

Getting Started With PRESCRIBED CABENUVA

  • How can ViiVConnect help providers and patients get started with prescribed CABENUVA?

    When CABENUVA has been prescribed, healthcare providers can complete the CABENUVA Enrollment Form with their patients and submit the form via the ViiVConnect Portal or fax. Once the form has been received, an Access Coordinator can help verify insurance coverage for prescribed CABENUVA, help eligible patients enroll for the CABENUVA Patient Savings Programs or the Patient Assistance Program (PAP),* schedule delivery of medication, and offer assistance with acquisition and reimbursement.

     

    *Subject to eligibility, program terms and conditions. ViiVConnect programs do not constitute health insurance.

  • How do healthcare providers acquire prescribed CABENUVA?

    Prescribed CABENUVA can be acquired through select Specialty Pharmacies or via the Buy and Bill process from a specialty distributor. The method will depend on whether your patient’s insurance plan covers the medication under the medical benefit or the pharmacy benefit.

  • What is the process for acquiring prescribed CABENUVA via Specialty Pharmacy?

    Specialty drug products that require special handling are obtained through a licensed Specialty Pharmacy that is equipped to facilitate dispensing, reimbursement, and case management. You can use a Specialty Pharmacy to acquire prescribed CABENUVA if your patient’s insurance covers them under the pharmacy benefit.

     

    Key things providers should know about ordering from a Specialty Pharmacy:

    • Your office and the Specialty Pharmacy will coordinate when to receive your product shipments
    • Patients pay any drug-related copays or coinsurance directly to the Specialty Pharmacy
  • What is the process for acquiring medicine via Buy and Bill?

    If you choose to use Buy and Bill for patients whose insurance covers prescribed CABENUVA under the medical benefit, you will purchase prescribed CABENUVA directly from a specialty distributor and store the medication on the premises until you prescribe and administer it. Buy and Bill allows your practice to manage the entire acquisition process.

     

    Key things providers should know about Buy and Bill ordering:

    • Your office will need to store and track your inventory of prescribed CABENUVA
    • Your practice submits reimbursement claims to payers
    • Your practice collects the copay or coinsurance from each patient

     

     

NEED HELP? TALK ONE-ON-ONE LIVE WITH OUR ACCESS COORDINATORS   
1-844-588-3288 (toll free)

We have programs for eligible patients who are insured, underinsured, and uninsured. 
Monday - Friday, 8AM - 11PM (ET).
Multilingual options available.

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