This is the less common form of coverage for NEXPLANON. It means that the drug is covered separately from the procedure.
After the pharmacy benefit is determined, a specialty pharmacy can deliver NEXPLANON to the practice.
These graphics denote a typical process for procurement. Procurement processes are subject to change. Contact your preferred procurement option for a complete overview of the current procurement process.
Benefit Investigation for Appropriate Patient
Once a patient and the HCP determine that NEXPLANON is appropriate, office submits the Customer Support Center for NEXPLANON enrollment form (via fax or patient portal) to determine coverage. The enrollment form also serves as a prescription
Specialty Pharmacy Selection
If insurance plan allows for a pharmacy benefit option, prescription is triaged to the appropriate specialty pharmacy preferred by that plan
Bill Insurance for Implant
Specialty pharmacy will bill insurance plan for NEXPLANON and will ship patient-specific NEXPLANON to the office
Office schedules patient for procedure
Patient returns to office for procedure
Bill Insurance for Procedure
Once procedure takes place, practice bills insurance carrier for procedure
AllianceRx Walgreens Prime
ASPN Pharmacies, LLC
CVS Specialty Pharmacy
Humana Specialty Pharmacy
Magellan Rx Pharmacy
The Customer Support Center for NEXPLANON (CSCN) may be able to help answer questions about:
- Patient benefit investigations
- Possible billing codes for insertion and removal
- Fulfillment of pharmacy prescription orders
- 1-844-639-4321M-F 8 AM-8 PM ET