BROVANA Reimbursement Information
BROVANA is covered for patients with chronic obstructive pulmonary disease (COPD), chronic bronchitis, or emphysema by most insurance plans, including commercial insurers (like HMOs or PPOs), Medicare, and Medicaid.
Coverage policies may vary by insurer, by state, or even between plans offered by the same insurer.
The various types of health insurance and their coverage of BROVANA are reviewed below.
Medicare: BROVANA is covered by Medicare under the Part B benefit.
The Medicare Part B program requires that patients have a diagnosis of COPD, chronic bronchitis, or emphysema, as indicated by the appropriate ICD-9 diagnosis code.
Effective December 1, 2009: Prior Use of a Nebulized SABA is No Longer a Medicare Part B Coverage Requirement for BROVANA
Patients are responsible for a 20% coinsurance under Medicare Part B. However, if they have supplemental insurance, their out-of-pocket cost may be covered fully or in part by their insurer. Ask your patients to check with their supplemental insurance provider for more details. For more information about the Medicare program, call 1-800-MEDICARE or visit www.medicare.gov.
For a list of Home Healthcare Providers accepting BROVANA Assignment and Processing Medicare Part B Claims, please click here.
Managed Care: Many managed care plans, such as HMOs and PPOs, cover BROVANA. These managed care plans may not have any coverage requirements for BROVANA.
A patient's managed care plan is likely to require some copayment or other cost-sharing for BROVANA. Ask your patients to check with their plan about coverage for BROVANA and their copayment responsibility.
Medicaid: Medicaid covers drugs and services for those who qualify. Some states have adopted guidelines governing the coverage of specific drugs. For more information about the Medicaid program or to locate a Medicaid contact in your state, call 1-800-MEDICAID.
