We understand that as a caregiver or an individual living with spinal muscular atrophy (SMA), life can be challenging. SMA360° is a support service from Biogen created to help families navigate various areas of the treatment process with SPINRAZA.*
The SMA360° team is made up of some important people: the Family Access Manager (FAM) and the Lead Case Manager (LCM). Read on to learn more about the roles they can play in your SPINRAZA experience.
Once a completed Start Form has been submitted to Biogen, your FAM will reach out to begin helping you with the logistics surrounding your treatment. The FAM will be your go-to person whenever you have a question or concern related to the logistics of your treatment journey while on SPINRAZA. Please remember that your/your child’s healthcare provider should be the primary resource for any questions related to SMA and SPINRAZA. The FAM can provide information on SMA360° support services and how you may be eligible for programs tailored to your needs.
Your FAM can:
- Coordinate the logistics of getting started with treatment
- Prepare you for the treatment journey by educating you on what to expect
- Connect with you at the treatment center, if you choose, to help with logistics as necessary
The relationship you have with your FAM should be one that’s comfortable for you and your family.
Click here for a step-by-step guide to starting SPINRAZA treatment, and how the SMA360° team can help.
INSURANCE AND FINANCIAL ASSISTANCE
Today’s ever-changing insurance landscape can be overwhelming. SMA360° Insurance and Financial Assistance Programs are designed to help you understand your insurance benefits for SPINRAZA and find an affordable way to start treatment and continue as prescribed by your healthcare provider.
To help you make informed decisions, an LCM can:
- Investigate your insurance benefits to help you understand your current coverage
- Collaborate with healthcare providers so that they can obtain prior authorization for treatment
- Provide support in the event of denied insurance claims
- Educate you on the eligibility details of the $0 Copay Program from Biogen, which can potentially cover both the cost of your SPINRAZA prescription and the treatment procedure
- Supply background and resources to refer you to third-party charity organizations
- Counsel you and your family on the possibility of adding or changing insurance coverage
You can contact an LCM at 1-844-4SPINRAZA (1-844-477-4672), Monday through Friday, from 8:30 AM – 8:00 PM ET, to get more information about these services.
Click here for information about available health insurance options and support services from Biogen.
Getting affordable access to treatment
There are 2 ways in which you may be eligible for financial assistance from Biogen’s $0 Copay Program: for SPINRAZA itself and for the treatment procedure.
Please note that these are 2 different programs, and you must enroll separately as needed.
$0 Drug Copay Program and $0 Procedure Copay Program
Generally, all individuals on non-government insurance are eligible, regardless of income, and there is no annual maximum on the amount Biogen will cover as part of the program. Insurance will be billed first, and must pay before copay assistance will be applicable.
Individuals receiving coverage from Medicare, Medicaid, the VA/DoD, TRICARE®, or any other governmental or pharmaceutical assistance may not be eligible. Contact an LCM for more information.
$0 Procedure Copay Program
In addition to the above criteria, you are eligible for this program if you meet the following requirements:
- You are not a resident of Massachusetts, Michigan, Minnesota, or Rhode Island
- Your healthcare provider submits a request for treatment using an approved procedure code for Anesthesia, Imaging procedures, and/or Surgical procedure/drug administration. Only codes approved by Biogen shall be eligible under the program
Third-party funding assistance
If it is determined that you are not eligible for the $0 Copay Program, an LCM can help you find charitable organizations that may provide third-party assistance.
TRICARE is a registered trademark of the Department of Defense (DoD), DHA. All rights reserved.
*SMA360° services from Biogen are available only to those who have been prescribed SPINRAZA. SMA360° is intended for US residents only.