Insurance Coverage
Is XYREM covered by insurance?
Yes, in most cases. A reimbursement team member will coordinate their XYREM coverage.
The XYREM Success Program and SDS Pharmacy cannot guarantee insurance coverage. However, the Admissions Specialist will:
- Call them to review their benefits and eligibility.
- Let them know if they have a co-pay or any out-of-pocket cost.
- Contact you, their doctor, if a prior authorization for XYREM is needed from the insurer.
- Help you and your patient with the insurance appeals process, if needed.
- Explain and help the patient with any other programs that may be available to help pay for their medication.
Important Information
Neither Jazz Pharmaceuticals nor the XYREM Success Program® guarantees reimbursement coverage for XYREM. In addition, neither Jazz Pharmaceuticals nor the XYREM Success Program assumes liability related to coverage and reimbursement for XYREM.
These materials are provided to you as guidance only and not a substitute for direct discussions with payers. Proper coding of claims is solely the responsibility of providers. Jazz Pharmaceuticals and the XYREM Success Program do not guarantee or warrant reimbursement coverage or reimbursement levels, as this is at the exclusive discretion of the payer. The information is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, policies, and payment amounts. Local payers, even local Medicare contractors, establish their own coverage, coding, and payment policies that might vary from what is provided in the guide. Information provided is for example only.
If you have any questions, please call 1-866-XYREM88® (1-866-997-3688).
To report an adverse event please call: 1-800-520-5568
