Once a decision has been made to prescribe SPRAVATO®
SPRAVATO withMe Case Managers provide you with educational support to help your patients start and stay on track.
Learn how to minimize delays in the approval process and get your patients on treatment quickly with the help of our Case Managers.
Benefits investigations for medical and pharmacy coverage
Prior authorization and appeals support
Coding and reimbursement support
Real-time notifications via a custom portal view with updates on your individual patients and accounts
A progress tracker that provides visibility to your patients’ access status
Patient affordability support
Confirmation on which pharmacies accept your patients’ insurance
Enrolling your patients in SPRAVATO withMe allows them to receive the following, regardless of insurance coverage:
*Care Navigators do not provide medical advice.
Information about your patients’ insurance coverage, cost support options, and treatment support is given by service providers for SPRAVATO withMe. The information you get does not require you or your patient to use any Janssen product. Because the information we give you comes from outside sources, SPRAVATO withMe cannot promise the information will be complete. SPRAVATO withMe cost support is not for patients in the Johnson & Johnson Patient Assistance Foundation.
Have drug and observation access and reimbursement information to help minimize denials and delays when getting your patients on treatment.
Once your patient is enrolled, as part of the benefits investigation, we’ll evaluate:
Medical and pharmacy benefit coverage
Behavioral health organizations (BHO) and employee-subsidized plan coverage
Prior authorization requirements, followed by appeals process if needed
REMS-certified pharmacy options that are accepted by the patient's insurance
Coding and reimbursement information, as well as appeals process
Affordability program eligibility
We'll help provide information and updates about the prior authorization and appeals process.
Our team can educate you on the prior authorization process by providing:
To help minimize timing delays and frustration due to coverage denials, SPRAVATO withMe has contracted with CoverMyMeds to offer electronic prior authorization support for pharmacy benefit access. As a result, you will be able to access your existing CoverMyMeds account and patients' history in the SPRAVATO withMe Provider Portal. This will help give you visibility into the process and allow you to track your patients' progress.
*We do not fill out any information that requires the medical judgment of the prescriber, and only the prescriber can determine whether to pursue a prior authorization.
Count on our Case Managers to identify pharmacy options for your patients.
You'll receive pharmacy options that have been verified for REMS certification and payer-mandated requirements. You will also be informed/know if the pharmacy accepts your patients' medical insurance or pharmacy drug benefits.
SPRAVATO withMe, alongside the Patient Access Specialist (PAS) team, can help educate you and your staff on which codes are accepted by your patients’ insurance plans.
Information about your patients’ insurance coverage, cost support options, and treatment support is given by service providers for SPRAVATO withMe. The information you get does not require you or your patient to use any Janssen product. Because the information we give you comes from outside sources, SPRAVATO withMe cannot promise the information will be complete. SPRAVATO withMe cost support is not for patients in the Johnson & Johnson Patient Assistance Foundation.
In addition to the support you provide, a SPRAVATO withMe Care Navigator will support your patients to help them start and stay on track throughout their treatment journey.
The treatment journey can be challenging for some patients. This is why the SPRAVATO withMe offers a dedicated Care Navigator with mental health experience.* Within 24 hours of enrollment,† a Care Navigator will be assigned to every patient, regardless of insurance coverage.
*Care Navigators do not provide medical advice.
†Or within the next business day.
They’ll offer one-to-one support and:
Help patients understand their insurance coverage
Provide patients with affordability options
Provide a Starter Kit to help patients at the beginning of their journey
Tailor communications to your patients and work with them to understand their needs
Assist with finding a REMS-certified SPRAVATO® treatment center
Help patients troubleshoot affordability challenges
Provide product and disease
state educational support
Most importantly, SPRAVATO withMe Care Navigators will be there with emotional support and encouragement at every step.
Care Navigators are available Monday through Friday, 8:00 AM to 8:00 PM ET. They will return your patients’ calls within the same day or the next business day.
Eligible commercially insured patients could pay $10 per treatment for SPRAVATO® out-of-pocket medication costs.
Eligible patients with commercial insurance pay as little as $10 per treatment for their SPRAVATO® medication. There are quantity limits and a savings limit each year. Program does not cover the cost of treatment observation. Patients may participate without sharing their income information. See program requirements.
SPRAVATO withMe can provide information about other resources that may be able to help your patients with their out-of-pocket medication costs:
The Johnson & Johnson Patient Assistance Foundation, Inc. (JJPAF) is an independent, nonprofit organization. JJPAF gives eligible patients free prescription medicines donated by Johnson & Johnson companies. Patients may be eligible if they don’t have insurance.
Do you have patients who may need help?
They can see if they are eligible and get an application at JJPAF.org or call 800-652- 6227 (Monday through Friday, 8:00 AM to 8:00 PM ET).
There are 2 ways to help your patients get started with their enrollment:
Download and fill out the Patient Enrollment Form and send it via fax to 844-577-7282
If you have any questions about enrolling your patients, give us a call at 1-844-4S-WITHME (1-844-479-4846), Monday through Friday, 8:00 AM to 8:00 PM ET.
