Patient Saver Non-Specialty Copay Assistance Program

This document is a guide detailing the EmpiRx Health Patient Saver Non-Specialty program, which serves as a cost containment solution aimed at reducing out-of-pocket expenses for members while also lowering plan costs. The program utilizes copay assistance funding from drug manufacturers to achieve these goals with minimal disruption to members. It outlines the process starting from the prescription claim being processed at the pharmacy, which may trigger a clinical review to ensure the medication prescribed is appropriate and cost-effective. The guide explains how members are facilitated through the eligibility and enrollment process for copay assistance, maximizing the financial support available to them. It also discusses the eligibility criteria for members, the information they will receive, and the actions required from them to enroll in the program. Additionally, it addresses how the program adapts when copay assistance is exhausted and the claim reverts to the standard plan design.