Editor’s Note: Having a chronic condition is hard enough. For far too many chronic care patients, medical challenges are compounded by financial ones. By helping patients find assistance for their medications, financial navigators play a critical role in boosting treatment affordability, access, and outcomes. In the first installment of our “Patient Stories” series, we share how a member of our TailorMed Complete team secured vital funding for patient with Crohn’s disease:

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Financial navigator: Greta Strom

Diagnosis: Crohn’s disease

Type of healthcare organization: Infusion center

Medication: Remicade

Assistance program: PAN foundation grant

Costs covered: $3,800 for the year

Patient financial responsibility without assistance: $500+ per monthly treatment

Patient financial responsibility with assistance: Less than $20 per monthly treatment

The story: A financial navigator from our TailorMed Complete team worked with a patient who receives monthly infusions of Remicade, a life-changing medication that helps control his Crohn’s and keeps him out of the hospital. After losing Medicaid coverage during the redetermination process, the patient enrolled in a Medicare plan. However, he was left with such a high copay that he was unable to continue treatment without financial assistance or a free drug program. 

Thanks to TailorMed’s fund alerts, our navigator was notified that an appropriate fund had opened at the PAN Foundation, and she was able to quickly enroll him. Since the grant from the PAN Foundation provided retroactive coverage, our navigator was also able to secure a refund for his payment on a previous treatment. These savings made a huge difference, enabling the patient to stay on therapy. 

Our navigator continued to work with the patient at the beginning of the new year when he encountered obstacles with the prior authorization process under his new insurance plan. Our navigator has been a vital resource to him throughout this process, and he calls her regularly to thank her for her invaluable support. By providing high-touch financial care, our navigator has improved the patient’s likelihood of treatment adherence and positive outcomes.

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Interested in partnering with our TailorMed Complete team to optimize financial assistance and reach more patients? Contact us to learn more.