REIMBURSEMENT FOR PILLCHECK

Many private insurance plans now cover Pillcheck. Pillcheck is known as a pharmacogenetic test and results are reviewed and reported on by licensed pharmacists. To determine if your plan provides coverage, here are some simple steps to follow:

Covered Benefits: Check your plan information for coverage of pharmacogenetic testing services. You may need a requisition form or prescription for the test from your doctor to be eligible for coverage. If your doctor writes a prescription for you, make sure it indicates “pharmacogenetic testing” and your condition.

You can download a requisition form here for your doctor to complete.

Confirm coverage if necessary: If your plan information doesn’t mention pharmacogenetics, you can submit information to the insurer or administrator about Pillcheck to confirm coverage. Insurance companies generally outline the process for doing this in plan materials.

We’ve created an information sheet for you describing important details that your insurer may need to determine if you’re covered.

Use the requisition form from step #1 above if one is required for coverage.

Healthcare Spending Accounts will provide reimbursement for Pillcheck. Order Pillcheck, and after you receive your results we will send you a receipt that you can submit for reimbursement.

Your Pillcheck results are kept private and will not be shared with your employer or insurer without your consent.

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REIMBURSEMENT FOR PILLCHECK

Pillcheck may be available to a person on disability claim through his or her disability management provider in order to support recovery and successful return to work.

The disability case manager facilitates the Pillcheck requisition for the claimant, pays for the cost, and sends a copy of the Pillcheck Pharmacist Opinion Letter to the claimant’s physician.

Pillcheck results have no impact on drug or disability insurance claims.

Participation is purely voluntary and subject to the claimant’s informed consent.

The case manager has access to the Pharmacist Opinion Letter summary and has no access to the claimant’s detailed genetic results. Data access is explained in the informed consent form.

The person on disability can contact his or her case manager to find out about eligibility for Pillcheck coverage.