Insurance Coverage Information

• Starting or Taking Tracleer
• Specialty Pharmacies
• Insurance Coverage and Financial Assistance
• Sure Steps
• LabTrac
• About Tracleer

Helping you find ways to pay for therapy

PAH Pathways counselors help simplify the process by:

• Verifying your insurance coverage
• Clarifying your co-payment amount before your prescription is filled
• Assisting with claims appeals and grievances
• Offering information about potential financial assistance for patients who are uninsured or who need help paying for their medication
• Assisting with Medicare/Medicaid issues, including program enrollment and drug assistance

Financial Assistance Programs

Tips for patients with private insurance

• Find out which PAH drugs are covered by your insurance plan
• Learn how to communicate with your insurance provider
• For more information on insurance-related matters, including a guide to insurance terms and questions to ask your insurance company, visit the Pulmonary Hypertension Association Web site.
• For additional information on Actelion reimbursement and financial programs, please contact us at 1-866-ACTELION (228-3546).

Tips for patients with Medicare/Medicaid coverage

• Discover
  • Prescription coverage: what you should know about Medicare Part B and Part D
  • PAH medicines covered under Medicare
  • Out-of-pocket costs
  • Claims appeals and grievances
  • For more information on these and other Medicare/Medicaid issues, visit the Medicare Web site, or the Centers for Medicare and Medicaid Services Web site, or call your reimbursement counselor

When you need help paying for therapy

• The PAH Pathways MasterCard^® provides the first month of Tracleer at no cost to most privately insured, eligible patients^*
• Caring Voice Coalition (CVC)^† offers a PAH co-pay assistance program for eligible patients
  • CVC may also provide assistance with insurance policy premiums, emergency financial needs, and peer support groups
  • Contact CVC toll free at 1-888-267-1440 or visit www.caringvoice.org

Medicare Part D

• Tracleer is covered for reimbursement under Medicare Part D
• CVC may offer assistance to those eligible patients who report a co-pay hardship
  • CVC offers assistance with selecting Part D plans
  • CVC may help at all levels of Medicare benefit structure

Medicaid and other government or public payers

• Medicaid and other public or government payers cover Tracleer in all 50 states¹
• The out-of-pocket cost for patients varies by state and program
• Typical co-pays are $5 or less for patients who have met their spend-down¹
  • Spend-down is a process that allows people with incomes above the Medicaid limit to still receive Medicaid. The process allows you to "spend down" your assets until you qualify for coverage

Uninsured

• If a patient is currently uninsured or is rendered uninsured and has demonstrated financial hardship, PAH Pathways offers both short- and long-term assistance programs for Tracleer access to eligible patients
  • Tracleer Patient Assistance Program (TPAP) may provide therapy at no cost to eligible patients and may be renewed
  • Tracleer Bridge program offers up to 90 days of Tracleer at no cost to patients who may experience a short-term coverage gap

*Ineligible patients: Any patients whose prescriptions are paid for by the government, Medicare, Medicaid, VA/DOD (Tricare), or Indian Health Service, patients in Massachusetts and Puerto Rico, or where prohibited by law.
†Caring Voice Coalition is a nonprofit, independent third-party organization.
MasterCard is a registered trademark of MasterCard International.

Reference: 1. Data on file, Actelion Pharmaceuticals US, Inc.