FAQ

At this time, Accessia Health only requests re-enrollment information every two (2) years based on your eligibility review date. There is not need to reenroll at the beginning of the year. If you are unsure of your review date, you can locate this information in your patient portal or by calling 800-366-7741 and using our automated system.

If you are unsure where your income falls according to Federal Poverty Limits (FPL), click here to view Accessia Health’s guidelines.

You can also calculate your FPL using this calculator tool here.

Accessia Health provides financial assistance for:

• health insurance premiums
• medication copayments
• travel (limited to a max assistance of $500 per year)
• other approved essential medical expenses**

 

**Coverage of items or services under Medical Expenses is determined at the sole discretion of Accessia Health; and is subject to change based on clinical correlation with covered diagnosis. Coverage of such items and services may not be appealed by any individual or company.

Questions related to specific items covered under Medical Expenses require clinical review for compliance purposes, and responses will be provided within 3-5 business days. Inquiries about coverage of medical expenses should be directed to assistance@accessiahealth.org.

We will send a determination of patient eligibility via postal mail or patient portal account once documentation has been reviewed.

You may check the status of your application(s) through the patient portal or speak with a representative at 1-800-366-7741.

Submit documents via:

• Log into your Patient Portal account to upload 
• Email: assistance@accessiahealth.org
• Fax: 804-744-9388
• Mail: PO Box 5930 Midlothian, VA 23112

Patients must meet financial and insurance requirements as well as have an eligible diagnosis. Documentation may be requested to confirm any of these requirements.

Ways to apply:

• Fill out our prescreen eligibility form
• Create a patient portal account
• Call to speak with a representative at (800) 366-7741

To be eligible for assistance, you must legally reside in the US or one its territories and receive treatment from a US provider.

At this time, Accessia Health only requests re-enrollment information every two (2) years based on your eligibility review date. There is not need to reenroll at the beginning of the year. If you are unsure of your review date, you can locate this information in your patient portal or by calling 800-366-7741 and using our automated system.

Assistance amounts have been finalized for 2024 and communications have been sent to those that have been impacted by any changes.

If you did not receive a letter in the mail or through your patient portal, the annual assistance amount for your program may not have changed.

All 2024 assistance amounts can be found on the patient programs page of our website. You can also send us a message through your patient portal account if you have questions about your assistance.

 

If you are unsure where your income falls according to Federal Poverty Limits (FPL), click here to view Accessia Health’s guidelines.

You can also calculate your FPL using this calculator tool here.

Accessia Health provides financial assistance for:

• health insurance premiums
• medication copayments
• travel (limited to a max assistance of $500 per year)
• other approved essential medical expenses**

 

**Coverage of items or services under Medical Expenses is determined at the sole discretion of Accessia Health; and is subject to change based on clinical correlation with covered diagnosis. Coverage of such items and services may not be appealed by any individual or company.

Questions related to specific items covered under Medical Expenses require clinical review for compliance purposes, and responses will be provided within 3-5 business days. Inquiries about coverage of medical expenses should be directed to assistance@accessiahealth.org.

Please visit your patient portal to learn more about how much assistance you utilized in 2023 and how it compares to the amount you will receive in 2024.

The maximum assistance amounts are determined on an annual basis. If your assistance amount is utilized before the end of the calendar year, we are unable to offer additional assistance in that year.

We encourage you to reach out to your provider’s office or pharmacy to discuss any additional resources. You can also find resources on the patient programs page.

Assistance from 2023 does not carry over to 2024.

Your assistance amount will reset on January 1, 2024.

Please visit the patient program page to see if any changes to the total assistance amount are noted for your 2024 assistance.

Accessia Health relies on the generosity of donors to fund our programs, so we can then support our patients. Funding amounts are carefully reviewed each year to determine how much assistance we can offer to reach as many patients as possible.

If Accessia Health has not made a payment on your behalf in four (4) months, your assistance will close. Once your assistance closes, you will need to reapply.

You may view pay history and remaining assistance amount through your patient portal account. This information may also be available by speaking with a representative at (800) 366-7741.

Claims must be submitted within 4 months from the date of service to be considered for payment.

For copayment assistance with your FDA approved and indicated medications for the program diagnosis, an Accessia Health pharmacy benefit card is mailed to you upon approval. To request another copy, call us at (800) 366-7741. In addition to your Accessia Health ID number, below is the information that is on your pharmacy benefit card and needed for your pharmacy to process a claim.

Rx BIN:610020
PCN:PXXPDMI
Click here to view a list of Group Codes by Program.

For all other assistance, a payment card will be provided for you to pay eligible vendors and/or providers directly. If you are unable to use your payment card, we may be able to reimburse you or pay the vendor directly via check.

Accessia Health has a 4-month timely filing limit for eligible claims or payments. Claims must be received within 4 months of the eligible date of service to be considered for payment.

Accessia Health provides copay assistance for eligible patients if the treatment prescribed by their physician is FDA approved and indicated for the program diagnosis.

Pharmacy claims may be submitted electronically for approved patients. Pharmacies must be contracted with our PBM vendor to submit electronic claims for pharmacy billing of eligible medication copays. Some helpful billing information is below.

Rx BIN: 610020
PCN: PXXPDMI
Click here to view a list of Group Codes by Program

If the pharmacy or provider has a date of service(s) that they wish to submit to Accessia Health, they may obtain the ID number from the patient.

Accessia Health may only provide very limited information to the pharmacy or provider. Correspondence is sent to the patient once an eligibility determination has been made.

Correspondence is sent to the patient once an eligibility determination has been made. The patient may contact Accessia Health to speak with a representative.

• Patient’s first and last name
• Patient’s date of birth
• Demographic information
• Health Insurance details
• Estimated household income
• Number of household dependents

Applications may be submitted here

• Fax: 804-744-9388
• Mailing Address: PO Box 5930 Midlothian VA 23112
• Email us at assistance@accessiahealth.org