EYLEA4U® Has One-on-One Coverage and Reimbursement Solutions

EYLEA4U can help with the following*

Benefit verification support

EYLEA4U support includes conducting a thorough benefit verification that summarizes your patient’s coverage, prior authorization (PA) requirements, patient cost share, and any additional coverage information available. Results of a benefit verification can be completed in as quickly as:

  • 60 seconds through EYLEA4U Connect
  • 48 hours by faxing the EYLEA4U enrollment form

PA support

Some insurance plans may require a PA before considering coverage for EYLEA.

Tips for handling PA requirements:

  • Complete the PA form. Some health plans accept a standardized form; others require you to complete a form they provide
  • Write a letter of medical necessity, if required
  • Attach copies of the front and back of the patient’s health plan card
  • Provide additional documentation, where applicable, that supports your treatment rationale
    • Prescribing information for EYLEA
    • Complete history of patient’s prior therapies and their outcomes
    • Clinical notes outlining your diagnosis for the patient

If a PA is required, a Reimbursement Specialist can review a patient’s health plan requirements and provide your office with information about the PA requirements for a specific payer

Appeals assistance

EYLEA4U is available to support your office if you decide to appeal a health plan’s decision to deny coverage for EYLEA. A Reimbursement Specialist can:

  • Provide information about PAs for EYLEA that have been denied
  • Explain the insurer’s appeal process

Claims assistance

If you received an incorrect claim for EYLEA or your claim was denied, EYLEA4U can:

  • Address questions on claims preparations
  • Review the status of an EYLEA claim with a patient’s insurer
  • Explain the insurer’s appeal process

*Subject to Regeneron policies.

Within 60 seconds, EYLEA4U will provide either a full benefit verification or notification that manual processing is required. Of the patients who received a benefit verification through EYLEA4U as of January 2020, over 40% received a full benefit verification report within 60 seconds. Manual processing may take up to 48 hours.

To download helpful resources from EYLEA4U, such as the Prior Authorization Checklist Flash Card, Appeals Kit, and Sample Letters of Medical Necessity, Exception, and Appeal, visit the Resources section.