Insurance Coverage
Is XYREM covered by insurance?
Yes, in most cases. An Admissions Specialist will coordinate your XYREM coverage.
The XYREM Success Program and SDS Pharmacy cannot guarantee insurance coverage. However, the Admissions Specialist will:
- Call you to review your benefits and eligibility.
- Let you know if you have a co-pay or any out-of-pocket cost.
- Contact your doctor if you need prior authorization for XYREM from your insurer.
- Help you and your doctor with the insurance appeals process, if needed.
- Explain and help you with any other programs that may be available to help pay for your 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).
Talk with a XYREM Patient Connection Mentor
The XYREM Patient Connection program provides an opportunity for you to talk one-on-one with a mentor who has been diagnosed with excessive daytime sleepiness and/or cataplexy with narcolepsy, and has been treated with XYREM.
