COVERAGE & REIMBURSEMENT INFORMATION FOR PREVYMIS

The Merck Access Program can help you understand the benefit investigation, prior authorization, and appeal process.

For more information, please select a category below.

Benefit Investigations
Prior Authorizations
Appeals

The Merck Access Program can contact insurers and may be able to obtain patient-specific coverage and benefits information for PREVYMIS, including:

whether the plan covers PREVYMIS

patient deductible, co-insurance, and out-of-pocket maximum amounts

whether the plan has prior authorization requirements

Getting started is simple

For patient-specific coverage questions

1. Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form.

If your patient is eligible and interested in co-pay assistance or the Merck Patient Assistance Program, please have the patient complete the appropriate sections.

2. Submit electronically, or print and fax the completed form to 866-866-4127.

3. A program representative will contact your patient and your office.

ENROLL NOW

If a prior authorization is required, or for assistance in understanding if a prior authorization is required, The Merck Access Program may be able to help.

The prior authorization checklist and sample letter at right can help you to understand the documents and information that may be helpful when seeking a prior authorization. As always, you should check for payer-specific requirements.

Download the Prior Authorization Checklist

Download the Sample Prior Authorization Letter

Getting started is simple

For patient-specific coverage questions

1. Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form.

If your patient is eligible and interested in co-pay assistance or the Merck Patient Assistance Program, please have the patient complete the appropriate sections.

2. Submit electronically, or print and fax the completed form to 866-866-4127.

3. A program representative will contact your patient and your office.

ENROLL NOW

If you have submitted a claim and the claim has been denied, you can submit an appeal to your patient’s insurer.

The appeal checklist and sample letter at right can help you to understand the documents and information that may be helpful when filing an appeal. As always, you should check for payer-specific requirements.

Download the Appeal Checklist

Download the Sample Appeal Letter

Getting started is simple

For patient-specific coverage questions

1. Download and complete the appropriate sections of the enrollment form, OR use the electronic enrollment form.

If your patient is eligible and interested in co-pay assistance or the Merck Patient Assistance Program, please have the patient complete the appropriate sections.

2. Submit electronically, or print and fax the completed form to 866-866-4127.

3. A program representative will contact your patient and your office.

ENROLL NOW

The information available here is compiled from sources believed to be accurate, but Merck makes no representation that it is accurate. This information is subject to change. Payer coding requirements may vary or change over time, so it is important to regularly check with each payer as to payer-specific requirements.

The information available here is not intended to be definitive or exhaustive, and is not intended to replace the guidance of a qualified professional advisor. Merck and its agents make no warranties or guarantees, express or implied, concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. The use of this information does not guarantee payment or that any payment received will cover your costs.

For more information, contact The Merck Access Program at 855-404-5278 Mon–Fri, 8 AM to 8 PM (ET), to speak to a representative.