JPAP Process

Patient with government insurance and BI result product not covered.

• Ineligible

• Refer to JJPAF

• Eligible

• Appeal

Patient prescribed pharmacy benefit and had medical coverage only.

• Enroll in Savings program

• Refer to Healthcare.gov

• Enroll in JPAP

• Refer to JJPAF

After speaking to patient or reviewing PEF to determine eligibility we'll need to update?

• Patient Contact Record

• The PPE Case

• The Enrollment case

• All of the above

Process of Reverification for 2024 BI and eligibility determination is

• December-January

• January-February

• November-December

• October-December

Xarelto product covered, and no PA required?

• Eligible JPAP

• Refer to JJPAF

• Refer to Savings Program

• Ineligible

Commercial Patient Product not covered ( Not IMM Product)

• Refer to JJPAF

• Eligible

• Ineligible

• Refer to Savings program

What document is needed for reverification?

• Completed application

• 4%Spend/EOB

• No documentations

• Insurance/PA

What queue should 2024 enrollment BI cases be assigned to

(a)  

BI completed 12/18/2023 and onward requires a new BI request submitted ?

• True

• False

Applications received after December 8, 2023 will be considered for the 2023 year?

• True

• False