Insurance FAQs

Navigating your insurance policy is not always easy. Below are some answers to frequently-asked questions that may be helpful.

What is a covered benefit?

A covered benefit is a medical service or supply that will be paid under the terms of the insurance plan. Thyrogen is a covered benefit under many private and public insurers.

What is a co-payment/co-insurance?

A co-payment/co-insurance is the amount that the patient must pay toward services, supplies and prescriptions that are covered benefits. The co-payment/co-insurance amount is set by the insurance company and may be a percentage amount or a fixed dollar amount. You may want to confirm the method for determining the co-payment/co-insurance amount with your insurance company.

What is a deductible?

A deductible is the amount of the covered benefits that must be paid by the patient before the insurance company will begin paying for benefits. Not all plans have a deductible.

What is an allowed amount?

An allowed amount is the maximum amount that will be paid for a covered benefit by the insurance company. It does not include the patient’s deductible and/or co-payment/co-insurance.

What is a pharmacy/prescription benefit?

A pharmacy/prescription benefit is a type of health insurance benefit that covers specific medications prescribed by a physician. Thyrogen may be covered as a pharmacy benefit under your plan.

What is a major medical benefit?

A major medical benefit is a type of health insurance benefit that covers illness and injury expenses. Benefits for prevention and diagnosis, as well as for treatment, are often included. Thyrogen may be covered as a major medical benefit under your plan.

What is an out of pocket expense?

An out of pocket expense is a health care cost that a patient must pay because it is not covered by the insurance plan. Out of pocket expenses include deductibles, co-payment/co-insurance, and amounts for services, supplies and prescriptions that are not covered benefits under the patient’s insurance plan.

Is there a program available for patients that are uninsured or those that have been denied insurance coverage for Thyrogen?

The Thyrogen Patient Support Program was established to help qualified patients receive Thyrogen. Please direct requests for application forms and questions about specific eligibility information regarding the program to ThyrogenONE at 1-88-THYROGEN (1-888-497-6436).