Gateway to NUCALA can help you understand the insurance process for covering NUCALA. You may also contact the specialty pharmacy, or patient’s payer directly.
Initiate a benefits investigation
Verify benefits by working with Gateway to NUCALA or contacting the payer directly. Benefits investigations do not guarantee coverage. If your patient is not enrolled in Gateway to NUCALA, please complete the enrollment form above.
If the patient will receive treatment at an alternative site of care (ASOC):
Consult the patient’s insurance or contact Gateway to NUCALA to identify an appropriate ASOC. Work with the ASOC to determine responsibility for benefits investigation and prior authorization.
Prior authorization (PA)
- Determine any PA requirements. Gateway to NUCALA can provide PA support for enrolled patients. Gateway to NUCALA cannot complete PA forms or submit related information to plans.
- Obtain needed forms from the patient’s plan
- Follow up with the patient’s plan to determine PA submission status if requested
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- If PA is denied, and you feel that NUCALA is appropriate for your patient, you can consider an appeal
- Gateway to NUCALA can help you and your patient understand the appeals process
- See below for sample letters of appeal and medical necessity