SUPPORT/SMA360º
Your SPINRAZA circle of
support
Your SPINRAZA circle of support
Once you or your child is prescribed SPINRAZA, you can learn about and access SMA360° support services from Biogen. Biogen’s SMA360° support program provides certain services that address nonmedical barriers to access.*
Your SMA360° team is made up of your Family Access Manager (FAM) and Lead Case Manager (LCM).
Together, they can help with:
Working with your Family Access Manager
Once a completed Start Form has been submitted to Biogen, your Family
Access Manager (FAM) will reach out to begin helping you with the logistics
surrounding your treatment. Your 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. Your 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
Please remember that your doctor should be your primary resource for any questions related to SMA and SPINRAZA.
Working with your Lead Case Manager
Today’s ever-changing insurance landscape can be overwhelming. Lead Case Managers (LCMs) are here to help you understand your insurance benefits for SPINRAZA and find an affordable way to start treatment
and continue as prescribed by your HCP.
To help you make informed decisions, an LCM can:
- Investigate your insurance benefits to help you understand your current coverage
- Facilitate the prior authorization process for treatment
- Provide information in the event of denied insurance claims
- Educate you on the eligibility details of the Biogen Copay Program, which may lower the out-of-pocket costs for commercially insured patients to as low as $0
- 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
Paying for treatment
There are two ways in which you may be eligible for financial assistance from the Biogen 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.
SPINRAZA COPAY COVERAGE
Generally, all individuals on nongovernment 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.
PROCEDURE COPAY COVERAGE
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 HCP 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 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° patient services from Biogen are available only to those who have been prescribed SPINRAZA. SMA360° is intended for US residents only.