TO LEARN MORE ABOUT RADICAVA®, SPEAK WITH A JOURNEYMATE RESOURCE SPECIALIST 1-855-457-6968. SEE MORE
TO LEARN MORE ABOUT RADICAVA®, SPEAK WITH A JOURNEYMATE RESOURCE SPECIALIST 1-855-457-6968. SEE MORE
Financial Support Options
Help With Navigating Your Options
We know that serious medical conditions can place financial burdens on many families. That’s why it’s a priority for us to help you understand financial support options for RADICAVA ORS® (edaravone) or RADICAVA® (edaravone) IV.
This page helps you understand your options. You can also download the Financial Support Options Overview for more information.
Where you receive treatment and how it’s covered can determine which financial support options are available to you. If you have been prescribed RADICAVA ORS® or RADICAVA® IV, it's important to understand your health plan coverage by downloading the Understanding Your Coverage and Costs for Treatment for details.
If you haven't talked with your doctor about RADICAVA®, visit the Starting RADICAVA ORS® or RADICAVA® IV page for information that may help you start the treatment conversation.
Your JourneyMate Support Program™ Insurance & Access Specialist is ready to help you!
An Insurance & Access Specialist will reach out to help you understand the insurance process and the infusion site-of-care selection process if you’re eligible to receive IV treatment.
This will happen after your doctor has prescribed RADICAVA ORS® or RADICAVA® IV and submitted a Benefit Investigation and Enrollment Form (BIF) which includes your signature to check your health insurance coverage.
An Insurance & Access Specialist will:
Help investigate your health insurance coverage and health plan benefits, as well as the RADICAVA® financial support options that may be available to you
Answer questions and let you know what’s needed next at each step in the process as you pursue treatment
Help you understand how to access your prescribed medication, whether it’s:
RADICAVA ORS® from a specialty pharmacy, or
RADICAVA® IV from an infusion therapy provider
If you’re switching from one formulation of edaravone to the other, your Insurance & Access Specialist is ready to help.
Commercial Health Insurance
Out-of-Pocket Assistance Program
Have you been diagnosed with ALS, prescribed RADICAVA®, and have commercial health insurance? If so, you may be able to save on out-of-pocket costs for your RADICAVA® prescription.
Benefits include:
Savings on your deductible, co-pay, and co-insurance costs for medication, and infusion costs, if applicablea (see footnote)
Paying as little as $0 per infusion or prescription
Your applicable out-of-pocket costs are covered—up to an annual maximum benefit per patient of $7,500 for RADICAVA ORS® or $20,000 for RADICAVA® IVb (see footnote)
Annual re-enrollment, available upon reverification of commercial insurance benefits to confirm your continued eligibility for the Out-of-Pocket Assistance Program
If you’ve been prescribed RADICAVA®, have commercial insurance, and meet the eligibility requirements:
You may have been enrolled in the Out-of-Pocket Assistance Program
OR YOU CAN:
Proactively apply by submitting the Out-of-Pocket Assistance Program Enrollment Form.
Learn more about the program and eligibility requirements with the Out-of-Pocket Assistance Program brochure for RADICAVA ORS® and RADICAVA® IV.
Out-of-Pocket Assistance Program Eligibility Requirements Updated May 2023.
The most recent eligibility requirement updates include:
If you are over the age of 65, you may qualify for the program if you meet all other eligibility criteria
For RADICAVA ORS®: if you have commercial prescription drug insurance and Medicare Part A (hospital benefit) and/or Medicare Part B (medical benefit) you are eligible if you meet all other eligibility criteria
For RADICAVA® IV: if you have commercial prescription drug insurance and Medicare Part A (hospital benefit) you are eligible if you meet all other eligibility criteria
| RADICAVA ORS® | RADICAVA® IV | |
|---|---|---|
| Offer | As little as $0 | As little as $0 |
| Annual Cap | $7,500 | $20,000 |
| Age | 18+ | 18+ |
| Residency | US or US Territories | US or US Territories |
| Insurance Required | Commercial Prescription Coverage | Commercial Prescription Coverage |
| Insurance Accepted | Medicare Part A Medicare Part B | Medicare Part A |
| Insurance Not Accepted(Patients enrolled in these government programs are not eligible to participate) | Medicare Part C Medicare Part D Medicaid VA DoD Tricare Any other government insurance (state or federal) | Medicare Part B Medicare Part C Medicare Part D Medicaid VA DoD Tricare Any other government insurance (state or federal) |
| Prescription Required? | Yes | Yes |
See full Eligibility Requirements & Terms and Conditions.
This is not insurance. The Out-of-Pocket Assistance Program is for eligible patients who have private, commercial health insurance with prescription coverage for RADICAVA ORS® or RADICAVA® IV which does not cover the entire cost of the medication. For RADICAVA ORS®, patients enrolled in commercial prescription drug insurance and Medicare Part A and/or Part B are eligible for assistance so long as they meet all other eligibility criteria and are not enrolled in or become enrolled in Medicare Parts C or D. For RADICAVA® IV, patients enrolled in commercial prescription drug insurance and Medicare Part A are eligible for assistance so long as they meet all other eligibility criteria and are not enrolled in or become enrolled in Medicare Parts B, C, or D. Support is not valid for patients covered, in whole or in part, by Medicaid, Department of Veterans Affairs (VA), Department of Defense (DoD), or any other federal or state health insurance program.
Other restrictions apply.
Government Health Insurance
If you or your loved one has been diagnosed with amyotrophic lateral sclerosis, there may be government health plan options to consider. A JourneyMate Support Program™ Insurance & Access Specialist can provide general information about those options, including:
Medicare
Social Security Disability Insurance
Medicaid
Medicare and Medicaid Dual Eligibility
Veterans Affairs
TRICARE
DoD
Review the Understanding Government Health Plan Options brochure for details about available options.
This brochure does not include a complete list or explanation of government health plans. Please visit HHS.gov for more information.
See the Helpful Information About Medicare’s Low-Income Subsidy brochure to learn how qualified Medicare Part D patients may save on prescription drugs.
This brochure does not include a complete explanation of the Low-Income Subsidy (LIS) program.
Uninsured Patients
Patient Assistance Program
If you have ALS and were prescribed RADICAVA®, you may qualify to participate in the Patient Assistance Program and receive RADICAVA® at no charge if you:
Are in financial need
Have no insurance
Meet certain requirements
One of the requirements is that your income isn't more than 5 times the Federal Poverty Level based on household size. Federal Poverty Level Guidelines are available here.
Only product provided at no charge. The Patient Assistance Program covers only the cost of RADICAVA ORS® or RADICAVA® IV and not the cost of any infusion services or healthcare provider visits, which are the sole responsibility of the patient.
Restrictions apply. See full Eligibility Requirements & Terms and Conditions for the Patient Assistance Program for RADICAVA ORS® and RADICAVA® IV.
The Patient Assistance Program brochure helps qualified uninsured patients in financial need learn about the program, eligibility requirements, and terms and conditions.
Alternate Support/Resource Information
Use the links or phone numbers below to learn about other sources of support for you and your loved ones.
Mitsubishi Tanabe Pharma America, Inc. is not affiliated with these resource organizations, which may have their own eligibility criteria and evaluation processes. By listing these resource organizations, Mitsubishi Tanabe Pharma America, Inc. is not endorsing any particular service or group and is not responsible for the content of these sites or services. These resource organizations are provided here for informational purposes and are not meant to replace your doctor's medical advice.
2023 Open Enrollment
The annual open enrollment period is the time of year you may reconsider your insurance coverage, make changes, or choose a new plan. It's important that you make sure to learn about your options.
Review the 2023 Open Enrollment Information for Patients brochure to understand coverage options.
This brochure does not include a complete list of health plan options.
A JourneyMate Support Program™ Insurance & Access Specialist is provided by UBC on behalf of Mitsubishi Tanabe Pharma America, Inc. (MTPA). A JourneyMate Support Program™ Insurance & Access Specialist may provide information obtained from outside sources about a patient's insurance coverage, financial support options, and whether treatment is covered by their health plan. This information does not require a patient or their doctor to use any MTPA product. Because the information provided comes from outside sources, a JourneyMate Support Program™ Insurance & Access Specialist cannot guarantee the information will be accurate or complete.
aPersons residing in Massachusetts, Minnesota, Michigan, and Rhode Island are eligible for out-of-pocket assistance for the cost of the drug only and are not eligible for other types of cost support for administration of the medication. Return to content
bYou will be responsible for any costs associated with RADICAVA ORS® or RADICAVA® IV above the annual maximum benefit. Return to content
