No. Typically your specialty pharmacy will contact you each month to see if you would like a refill of your Jakafi. If you don’t receive this call, you can call your specialty pharmacy directly or contact IncyteCARES for Jakafi.

Call IncyteCARES for Jakafi about any insurance changes, and we can help you understand your new coverage. We can also determine if you are now, or are still, eligible for our IncyteCARES for Jakafi Savings Program or other financial assistance programs. Your new insurance company may require you to use a different specialty pharmacy to fill your prescription. We can help you change pharmacies if needed and coordinate your medicine delivery from the new pharmacy.

Yes. You can always send prescriptions directly to a participating Jakafi specialty pharmacy. Keep in mind, however, that IncyteCARES for Jakafi can offer helpful services, particularly if you don't have prescription drug coverage.

Check with your specialty pharmacy. It may provide a refill reminder service.

Jakafi prescriptions can be filled by these specialty pharmacies. Note that your insurance company may require you to use certain pharmacies to fill your prescription.

Once we receive your insurance information, we can research your coverage for Jakafi right away. In most cases, we’ll call you with this information within 3 business days. If there is a delay, we’ll notify you and/or your Healthcare Professional within that time frame.

Many insurance plans require prior authorization before they will approve coverage for Jakafi. This means they require your Healthcare Professional to send them additional information about your condition and why Jakafi is being prescribed. Based on the additional details, they will determine coverage. In most cases, this extra step delays their coverage approval by just a few days. In the unusual event that your insurance company delays their coverage decision by more than a few business days, we may offer you a free short-term supply of Jakafi through our IncyteCARES for Jakafi Temporary Access Program.

Your enrollment in the IncyteCARES for Jakafi program lasts for one year. That means you must re-enroll annually by submitting a new enrollment form. At that time, we also have to reconfirm your insurance coverage for Jakafi.

Please contact IncyteCARES for Jakafi if your insurance coverage changes or is lost or if you have a life-changing event such as a job loss or other change in household income. We can determine any changes in your coverage for Jakafi or your out-of-pocket costs. We can also find out if your specialty pharmacy is still within network for your insurer and can communicate any changes to them. If you need to change specialty pharmacies, we can help with that as well.

Copay adjustment programs are used by health insurance companies—mostly for specialty medications that have drug manufacturer copay savings programs. Health plans use adjustment programs to offset what they pay for a medication rather than allow the manufacturers’ savings program to be applied to the patient's out-of-pocket costs and deductibles as it was intended to be.

As drug manufacturers attempt to create programs to subsidize out-of-pocket costs for patients, the payers reduce the value of these programs by exhausting such funds while also requiring the patient to pay their deductibles and coinsurance up to their out-of-pocket maximums to obtain their medications.

Copay adjustment programs may vary in name, but traditionally they are called copay accumulators or maximizers. Patients may often have difficulty knowing if their health insurance program includes accumulators and maximizers. In some cases, patients are offered reduced costs by the health plan if they enroll in a particular program.

The most common types of copay adjustment programs are accumulators and maximizers. These programs are designed to exclude the use of manufacturer copay savings programs from counting toward patients’ annual deductibles and out-of-pocket costs, such as copays.

• An accumulator adjustment program is used by the plan/pharmacy benefit managers (PBMs) to prevent manufacturers’ copay savings from being applied to deductibles and maximum out-of-pocket cost. That means that the value of the copay savings program goes directly to the plan rather than being subtracted from the patient’s annual deductible or out-of-pocket expenses. Once the full value of the copay savings is used, the patient is still responsible for their full or remaining deductible and out-of-pocket cost
• A maximizer adjustment program is used to adjust the patient’s copay responsibility to match the maximum value of the manufacturer’s savings program. Generally, the value is divided over the year, a shorter specified period of time determined by the plan, or the number of months a patient is on the product within a calendar year to extract the full value of the copay savings program. For plans to use maximizers, the insurance company deems the specialty drug nonessential so that they are not limited to the Affordable Care Act (ACA) maximums

First, take look at your plan details. The explanation of benefits (EOB) report is a good place to start.

Your health insurance company can provide your EOB upon request. The document should describe how to meet your deductible and out-of-pocket maximum. You can also ask your employer if your plan includes these programs.

Next, review your insurance plan’s Pharmacy Limitations and Exclusions or Schedule of Benefits statement.

Be on the lookout for terms like “manufacturer,” “copay card,” “coupon,” and “discount.” These keywords can help you find the restrictions or limitations for financial assistance you may receive from drug manufacturers.

You can contact a customer service agent from your insurance company who may help you find out if the plan you are enrolled in (or are considering) has a copay adjustment program that could change your out-of-pocket costs.

Straightforward questions to ask include:

• Does this health plan have an accumulator or maximizer program?
• How does it impact me?
• What are my options for handling gaps in coverage that may occur?
• Am I required to enroll, or may I opt out?
• If I can opt out, can I do so at any time of the year or only during open enrollment?