Educating Insurers

You already have a lot to think about. Treatment is top of mind, but with treatment comes cost, and with cost comes coverage concerns. That’s why it’s essential to know the ins and outs of your insurance policy – and to help your insurer understand your needs.

Think Ahead, Act Now

Knowledge and planning are essential. Consider the possibility that your current insurance may not cover everything this year and in the years ahead.

If no coverage is provided for your treatment, you may still be able to work with your insurer to gain coverage. You might also want to consider adding supplemental coverage – or start saving for any out-of-pocket expenses.

Learn how The GARDian Program Insurance Support can help

Educating Your Insurers

People with rare diseases sometimes find that decision makers at health insurance companies aren’t familiar with their health conditions. Educating your insurer is essential to:

• Avoid denials of service
• Lay the groundwork for necessary services, specialist visits, and therapy.

The Case for Having a Case Manager

If your insurance company doesn’t assign you a case manager, ask for one. Building a relationship with your case manager can help you:

• Navigate requirements, documents, forms
• Choose your brand of therapy and your Specialty Pharmacy Provider
• Track deductibles, and any annual limits

Your case manager may need more information about primary immune deficiency. You can point out resources on immunedisease.com, the Immune Deficiency Foundation website, or the Jeffrey Modell Foundation website, or point them to this insurance guide. The more your case manager understands about your health condition and your family’s situation, the more assistance you may receive.