Your insurance and coverage questions – answered

Consider asking these questions and contacting Bayer Access Solutions at 1-800-288-8374 for more specific information for your situation.

  • What is covered?
  • How much does insurance cost?
  • What is the pharmacy coverage?
  • Is factor covered? If so, how is it billed?
  • What is your co-pay amount – the amount you will pay upfront for services (doctors' visits, etc.)?
  • What is your deductible – the amount you are responsible for before your insurance policy begins coverage?
  • What are your out-of-pocket (OOP) expenses – the amount of money that you will be responsible for?
  • Is it an HMO, PPO or POS policy?
    • HMO – Health Managed Organization: Provides employers a way to take care of all their employees' healthcare needs with reduced costs by negotiating with specific doctors, hospitals and clinics. These specific providers must be used by the employee.
    • PPO – Preferred Provider Organization: This is similar to an HMO, but the employees can choose the physician they want to see instead of being restricted to the HMO providers. An employee can choose between a member or nonmember provider. The member provider would be the least expensive choice for the employee.
    • POS – Point of Service: Employees can choose their own physician who has previously agreed to provide services at a discounted fee. In a POS, the employee would have to use the chosen physician as a gateway before moving on to a specialist. In other words, if the employee has a medical issue, the POS physician must be contacted first in order to obtain the most benefit from the health insurance plan.
    • Is the physician of your choice (pediatrician, hematologist, etc.) listed in the policy you are choosing? If not, you will pay out-of-pocket expenses for their services.

You have three options. For more information about each, please call Bayer Access Solutions at 1-800-288-8374.

  1. COBRA requires employers with 20 or more employees to continue coverage. Children can be covered under a parent's plan for up to 36 months. The child is responsible for the costs of the plan.
  2. Individual insurance
  3. Employer insurance

If you have private, commercial healthcare insurance, you may qualify for the $0 Co-pay Program administered by Patient Services, Inc. (PSI). Give Bayer Access Solutions a call at 1-800-288-8374, and we can quickly help determine the financial assistance you may be eligible to receive.

More than one person in a household can receive up to $12,000 in co-pay assistance. Your income will not affect your eligibility for the program.

The program is not for patients receiving prescription reimbursement under any federal-, state- or government-funded insurance programs, or where prohibited by law.

If you become unemployed or have a lapse in private insurance coverage, you may qualify for temporary insurance through our GAP Coverage Card Program. Call Bayer Access Solutions at 1-800-288-8374, and we can quickly help determine your eligibility.

If you do not have insurance or lack third-party coverage for Kogenate FS, we may be able to provide you with Kogenate FS through our Patient Assistance Program. Call Bayer Access Solutions at 1-800-288-8374, and we can quickly help determine your eligibility.

If you are newly diagnosed or currently using another factor VIII treatment, you may qualify for up to six free doses of Kogenate FS – to a maximum of 5,000 IU for new patients and 20,000 IU for previously treated patients.

People who were previously enrolled in the Kogenate FS Free Trial program and those currently receiving Kogenate FS therapy are not eligible to participate.

For more information, please call 1-800-288-8374. Or download the enrollment form.

Talk with your doctor about whether Kogenate FS is right for you and follow these simple steps to apply for the Kogenate FS Free Trial program.

The Kogenate® FS Free Trial Program is available to newly diagnosed patients and patients who are currently using other FVIII therapy. Patients currently using Kogenate® FS are not eligible for the Free Trial Program. Participation in the Kogenate® FS Free Trial Program is limited to one time each for both BIO-SET® and Vial Adapter reconstitution devices. The medication provided through this program is complimentary and is not an obligation to purchase or use Kogenate® FS in the future. Reselling or billing any third party for the free product is prohibited by law.

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