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This topic has 3 replies, 3 voices, and was last updated 5 months ago by Yvette Haas.

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    • #25513
      Brianna Albers
      Keymaster

      I finally met with a neurologist who’s familiar with SMA! They’re going to submit the forms to insurance re: Evrysdi (risdiplam) and get back to me. I’m so happy!

      Has anyone been denied by insurance so far?

    • #25543
      Greg Sealey
      Participant

      My experience is that Insurance typically denies coverage initially. Your doctor then appeals.  Insurance usually then approves.

      Even with approval, your out-of-pocket/copay may still be astronomical.  No worries though, Genentech can connect you with copay assistance providers, if needed.  This may bring your actual copay to $0, or nearly $0.

      Get to know your PAL at Genentech. They will be a tremendous help in this somewhat scary process.

    • #25545
      DeAnn R
      Keymaster

      I received a letter saying it’s approved for me.  No denial.  I was on Spinraza, so don’t know if that makes a difference.  Glad to hear you’re making progress!

    • #25552
      Yvette Haas
      Participant

      I was approved by Medicare within about ten days. If it makes any difference, I was not on Spinraza previously.

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