Protect Yourself From a Lapse in Coverage
Frequently Asked Questions
What is the CSL Behring Assurance program?
CSL Behring Assurance is designed to help ensure that people who rely on the CSL Behring therapies eligible under the program can continue to receive these vital treatments even if they experience a lapse in third-party, private health insurance.
Why should I enroll in the program?
Hopefully, you and your family will never experience a lapse in your health insurance. However, whether caused by a loss of employment or your dependent status, a change in carrier, or even exceeding your lifetime maximum coverage—insurance gaps can happen and it is critical to have a backup plan.
Who is eligible to enroll?
Anyone who uses a CSL Behring therapy that is included in the program, has third-party private health insurance,
and is a US citizen, a legal resident of the US, or has a current US visa*, may enroll in CSL Behring Assurance.
Third-party private health insurance types include, but are not limited to:
- Health Maintenance Organization (HMO) plans
- Preferred Provider Organization (PPO) plans
- Fee-for-service plans administered by private companies
The types of insurance that are NOT third-party private coverage are plans in which claims are paid from federal, state, and/or local budgets, including:
- Medicare Parts A, B, & D
- Medicare Advantage Plans
- Medicaid Managed Care
- Veterans Administration (VA)
- State Children's Health Plans (SCHIPs)
- Preexisting Condition Insurance Plans (PCIPs)
TRICARE and federal and state employees can participate in CSL Behring Assurance if they are covered by private third-party insurance policies.
How does the program work?
After you have enrolled in the CSL Behring Assurance program, you will receive 1 Assurance point for every month of continued product use of an eligible
CSL Behring therapy.* Points are issued based on product use from your enrollment date. You can earn up to 12 points per year.
If you experience a lapse in your third-party private insurance, simply contact a CSL Behring Assurance Care Coordinator. Upon verification of the lapse
in insurance and continued CSL Behring product use, you may redeem points for a monthly supply of your CSL Behring therapy. Three points may be redeemed for
a one-month product supply based on product usage at the time of redemption.† Please see complete program Terms and Conditions for details.
How much is 1 point worth?
For every month of continued use of a CSL Behring therapy, you can earn 1 CSL Behring Assurance point. You may earn up to 12 Assurance points during
a 12-month enrollment period. Assurance points expire 5 years after they are awarded.
Three points represent a one-month product supply based on product usage at the time of redemption. For information on monthly product supply please see:
Coagulation Therapies, Immunology Therapies,
or Alpha-1 Therapy, as applicable.
How many points can I earn each year?
You may earn up to 12 Assurance points during a 12-month enrollment period. This is worth up to 4 months of product per year if you redeem the points
when your insurance lapses. Assurance points are not transferable and expire 5 years after they are awarded.
Are my Assurance Certificates still valid?
No. In November 2014, we switched from Certificates to the point system. However, any unused Assurance certificates you have earned have been converted to
Assurance points; each certificate equals 3 Assurance points. To get your current point balance please contact your CSL Behring Assurance
Care Coordinator at 866-415-2164.
If I have high dosing requirements, how many points do I need to redeem each month's supply of product?
CSL Behring Assurance is designed to be flexible, enabling you to redeem more than 3 points for each month's supply, in order to meet your dosing
requirements. You may redeem multiple points in increments of 3 to fill a single prescription, with a maximum of 12 points per prescription.
Prescription fulfillment is based on product usage at the time of redemption. You may not exceed the annual limits for the product.
Is CSL Behring Assurance the same as the Patient Assistance ProgramSM?
No. The CSL Behring Assurance requires patients to enroll and have third-party, private health insurance. Once enrolled, patients earn points for
continued monthly product use. If they suffer a lapse in their third-party private health insurance they can redeem points and continue receiving their
CSL Behring therapy. There are no financial requirements to enroll or receive product in this program.
The Patient Assistance Program provides access to CSL Behring therapies for qualified patients who are uninsured or under-insured. Patients must meet financial
requirements of this program to receive product.
How can I sign up?
Enrolling is easy. You can complete the secure online form or call the toll-free CSL Behring Assurance Hotline at 1-866-415-2164.
Enrollment can occur anytime during the calendar year. Patients are considered enrolled when the CSL Behring Assurance Care Coordination Center has verified
eligibility and all other program requirements have been met.
Once your enrollment information has been verified, you'll receive a Welcome letter with more information about the CSL Behring Assurance program.
How would it affect my enrollment if my doctor switches me from one CSL Behring product to another?
If you are currently enrolled in the CSL Behring Assurance program, neither your enrollment nor the status of your Assurance points
will be affected if your doctor recommends that you switch from one qualifying CSL Behring product to another.
If you experience a lapse in your health insurance, you will be able to redeem any points for products using the Assurance points accrued
while using your previous CSL Behring product to secure your current treatment.
What if I enroll and lose my insurance before the first 3 months are up?
A CSL Behring Assurance Care Coordinator will work with you to address this situation. For example, the CSL Behring Assurance Care Coordinator may determine whether you qualify for CSL Behring's Patient Assistance Program, and may work with you and your healthcare provider to seek other insurance solutions, while providing complimentary product to qualified patients. Once you have secured new third-party, private health insurance, you can re-enroll in CSL Behring Assurance.
What if I don't need treatment every month?
If your doctor changes the frequency of your treatment and you are not using another company's product, you can continue in the CSL Behring Assurance
program provided your doctor provides validation to a CSL Behring Assurance Care Coordinator.
If you experience a lapse in your health insurance coverage prior to being enrolled for 3 months, please contact a CSL Behring Assurance Care Coordinator.
He/she will work with you to address your situation.
What if I use more product than the maximum amount redeemable?
You can always get the amount of product you need up to the annual maximums. If your product needs exceed those amounts, a CSL Behring Assurance
Care Coordinator will work with you to find alternate means by which you can obtain product.
I did not realize my product supplier switched my brand of product. Am I still enrolled? Are my previous points still valid?
If you are switched from a CSL Behring product without your knowledge, you can remain in the program, and all previously earned points will remain valid. When you start using a CSL product again, you will resume earning points.
What if I stopped therapy during the previous quarter?
If your doctor has instructed you to temporarily stop using your CSL Behring therapy (not replaced with product from another manufacturer), you can remain in
the program, and all previously earned points will remain valid.
CSL Behring Assurance points are not valid for non-CSL Behring products. If you are switched from a CSL Behring product without your knowledge, you can remain
in the program, and all previously earned points will remain valid. When you start using a CSL product again (with appropriate validations from your doctor), you will resume earning points.
Why is the program not available to people who have Medicaid or Medicare?
Due to current laws and regulations governing federally funded healthcare programs, this program cannot be offered to Medicaid or Medicare recipients.
Are state/federal employees eligible?
The fact that you work for a state or federal agency does not exclude you from participating in the CSL Behring Assurance program. The determining factor is whether you have third-party, private health insurance. If so, you may be eligible to participate in this program. However, if you receive Medicaid or Medicare reimbursement, you are not eligible to participate in this program.
Will the program provide cash instead of product?
No. The CSL Behring Assurance program is designed to help ensure that people who rely on the CSL Behring therapies eligible under the program can continue to receive these vital treatments even if they experience a lapse in third-party, private health insurance.
I can't afford my co-pay/premium/deductible. Can the program help?
CSL Behring Assurance is designed to assist patients who experience a lapse in third-party, private health insurance. However, the CSL Behring Assurance
Care Coordinators may be able to help you better manage the issues with your co-pay/premium/deductible. They will work with you to identify potential sources of supplemental or alternative coverage.
How is CSL Behring protecting patient privacy?
To help ensure your privacy, the CSL Behring Assurance program is being managed by an independent company that specializes in these types of programs. CSL Behring will not have access to any of your confidential information without your consent.