Product Access Program
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We're here for you
Searchlight Support® provides education and assistance for people who receive RADICAVA® (edaravone) and those who care for them. Our Care Coordinators are ready to help.
Out-of-Pocket Cost Support Options
We can help you obtain co-pay assistance, if eligible
Infusion Center Directory
We can help you find an infusion site of care
To be enrolled in Searchlight Support®, your healthcare provider (HCP) must prescribe RADICAVA® for you. You will also need to provide authorization for enrollment in the program by reading and signing one of these forms:
- The form your HCP submits the first time they order RADICAVA® for you (a Benefit Investigation and Enrollment Form)
- A separate Patient Authorization Form
A Patient Authorization Form is available here, if you need one.
You can submit your signed form by:
1-888-782-6157
PO Box 2930
Phoenix, AZ 85062
Once enrolled in Searchlight Support®, one of our Care Coordinators will be assigned to assist you and will reach out to offer care coordination and out-of-pocket cost support options that may be available to you.
Out-of-Pocket Cost Support Options
We understand that serious medical conditions place a financial burden on many families. That’s why Searchlight Support® helps to provide affordable access to RADICAVA®.
Our dedicated Searchlight Support® Care Coordinators can help you navigate cost support options that may be available to you. But first, you may want to learn about some of these options below.
Out-of-Pocket Assistance Program
Support for eligible patients with commercial insurance
Eligible, commercially insured patients may be automatically enrolled when their healthcare provider submits a Benefit Investigation and Enrollment Form for RADICAVA®.
If you are enrolled in the program, you will:
- Save on your deductible, co-pay, and co-insurance costs for RADICAVA® and for your infusionsb
- Pay as little as $0 per infusion
- Your applicable out-of-pocket costs are covered–up to $20,000 per calendar yearc
- Automatic re-enrollment for the next calendar year, if eligible
Assistance is not valid for patients covered, in whole or in part, by government-funded health insurance such as Medicare, Medicare Part D, or Medicaid.
bPersons 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.
cYou will be responsible for any out-of-pocket costs above the maximum annual program benefit.
A program designed to help with treatment costs
Your personalized program card will be used by your infusion provider to submit reimbursement claims to the Searchlight Support® Out-of-Pocket Assistance Program (the Program).
IMPORTANT!
Please make sure to bring your program card to all of your treatment appointments.
- How this program works
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At enrollment, Searchlight Support® will:
- Review your insurance benefits to determine your out-of-pocket costs, and confirm your eligibility for the Program, including verifying commercial insurance
- Call to explain your insurance benefits and answer any questions you may have
- If eligible, send you a welcome letter with a program card
At time of treatment, your infusion provider will:
- Submit a claim for medication and infusion costsd to your primary health insurance plan
- Complete and submit a reimbursement claim for your applicable out-of-pocket costs using your program card
Searchlight Support® will issue payment to your infusion provider following validation of all required claim information, including the Explanation of Benefits (EOB) from your health plan.
If you’ve already paid your out-of-pocket costs to your infusion provider for costs related to your treatment OR to a specialty pharmacy for the cost of RADICAVA®, complete and submit a Request for Out-of-Pocket Assistance Form, along with the required EOB or pharmacy receipt.
You may receive a check for applicable out-of-pocket costs following validation of all required claim information. Requests must be submitted within 365 days of the date of service.
dPersons 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.
Restrictions apply. See Eligibility Requirements & Terms and Conditions.
Out-of-Pocket Assistance Program Enrollment Form
Ask your healthcare provider if they have or will be submitting a Benefit Investigation and Enrollment Form for RADICAVA®. If not, you can also enroll by using the Out-of-Pocket Assistance Program Enrollment Form.
Request for Out-of-Pocket Assistance Form
Use this form if you are enrolled in the Out-of-Pocket Assistance Program and have already paid your out-of-pocket costs to your infusion provider for costs related to your treatment or to a specialty pharmacy for the cost of RADICAVA®.
Resources for patients who are uninsured
The Searchlight Support® Patient Assistance Program (PAP) can help uninsured patients who are in financial need. Patients who meet Program requirements may be able to receive medication at no charge for up to 2 years. The patient must be a citizen or a permanent resident of the US or its territories, and reside in the US or its territories. The patient's income must not exceed 5 times the Federal Poverty Level based on household size (Federal Poverty Level Guidelines are available at https://aspe.hhs.gov/poverty-guidelines).
- How this program works
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- You and your HCP complete the Benefit Investigation and Enrollment Form and submit to Searchlight Support® with all required documentation.
- If you meet the Patient Assistance Program requirements, the program will cover your RADICAVA® medication as prescribed by your HCP at no charge for 1 year.e
- You must reconfirm your eligibility for continued participation in the program after your initial 12-month eligibility period by providing required financial documentation.
- If you continue to meet the program requirements, you may be able to receive your medication at no charge for an additional 12 months.
eOnly product provided at no charge. The Patient Assistance Program covers only the cost of RADICAVA® and not the cost of any infusion services or healthcare provider visits, which are the sole responsibility of the patient.
Restrictions apply. See Eligibility Requirements & Terms and Conditions.
Alternative coverage research
Searchlight Support® can help research alternative coverage options, as well as provide information about independent charitable organizations that may be able to provide financial support.f
fCharitable foundations and other third-party patient support organizations are independent from Mitsubishi Tanabe Pharma America, Inc. Each third-party organization has its own eligibility criteria and evaluation process, and Mitsubishi Tanabe Pharma America, Inc. cannot guarantee that patients will receive assistance.
2019 Open Enrollment Information for Patients
The 2019 Open Enrollment Information for Patients brochure is designed to help you understand general coverage options, even if infusions are received at multiple locations, such as at a doctor’s office, an infusion center, a hospital outpatient department, or at home. During Open Enrollment, you can review your insurance coverage and make changes, or you can choose a new plan. Since this brochure does not include a complete list of health plan options, please contact your health insurance company or medicare.gov for specific information.
To learn more, download the 2019 Open Enrollment Information for Patients brochure. If you have questions, please call Searchlight Support® at 1-844-SRCHLGT (1-844-772-4548).
Infusion Center Directory
If you receive RADICAVA® outside your home, Searchlight Support® can help you find an infusion site of care that is based on:
- Where you live
- Your insurance
- The centers' hours of operation
Contact Searchlight Support® at
Find a Doctor
Use the ALS Care Locator to find a doctor closest to you, including those who have prescribed RADICAVA®.
Searchlight Support® FAQs
- Who can use Searchlight Support®?
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To help people with ALS access treatment with RADICAVA®, Searchlight Support® offers programs and assistance for healthcare providers and people who receive RADICAVA®. Caregivers may also seek support on behalf of a loved one who receives RADICAVA®.
For questions about how Searchlight Support® can help, call at Searchlight Support® at
1-844-SRCHLGT (1-844-772-4548) . - How do I enroll for help from Searchlight Support®?
To be enrolled in Searchlight Support®, your healthcare provider must order RADICAVA® for you. You will also need to sign a form to authorize your enrollment in the program.
- Can I get help paying for RADICAVA®?
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Searchlight Support® can give you information about out-of-pocket cost support programs and other sources of financial assistance that may be available to you.
If your healthcare provider includes all of the details needed when they first order RADICAVA® for you, you may be automatically enrolled in either the Searchlight Support® Out-of-Pocket Assistance Program or Patient Assistance Program, if you are eligible.
For questions about out-of-pocket cost support, call Searchlight Support® at 1-844-SRCHLGT (1-844-772-4548).
- What can I do if my insurance company denies coverage for RADICAVA®?
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Your insurance company may initially deny your treatment with RADICAVA®. If this happens, you may be able to do something about it. Here are some ideas you may find helpful:
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Talk to your healthcare provider (HCP) and call your insurance provider to request an “exception” for coverage of your medication
If you have been notified that your medication is not covered by your health plan or that you need to meet other requirements before obtaining it, you can call your insurance provider and request an “exception” for coverage of your medication.
Review this guide for some helpful steps you may follow: Requesting an Exception from Your Health Plan.
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Talk to your HCP to see if it may be possible to file an appeal
If your request for an exception is denied you may be able to appeal the decision.
Having your HCP file an appeal may help give your insurance provider more details about why you should receive treatment.
If the appeal does not work, your HCP may request a next-level appeal. Some of the people that may be involved include a panel of HCPs, an administrative judge, or a local state representative.
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Consider other insurance plan options
For example, even if you are under 65, you may be eligible for Medicare or Social Security Disability Insurance (SSDI).
For questions about appeals or insurance coverage, call Searchlight Support® at 1-844-SRCHLGT (1-844-772-4548) to learn more.
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Talk to your healthcare provider (HCP) and call your insurance provider to request an “exception” for coverage of your medication
- What can I do if I am denied infusion by a site of care?
If your preferred site of care is unable to accommodate you, our National Infusion Center Directory may help identify another location. Call Searchlight Support® at 1-844-SRCHLGT (1-844-772-4548) to learn more.
- How do I renew my eligibility for out-of-pocket support into 2019?
Completion of the OOP Insurance Verification Form is required to confirm your continued eligibility for the Searchlight Support® Out-of-Pocket Assistance Program and to process 2019 reimbursement claims. Please complete and fax this form to 1-888-782-6157 or submit to Searchlight Support®, PO Box 2930, Phoenix, AZ 85062.
To learn more, call
The information and advice provided here are general in nature and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. You are strongly encouraged to seek the advice of your doctor or other qualified healthcare provider with any questions regarding a medical condition.
