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- Administration Guide (PDF)
- Optimal Use of ILUVIEN Applicator (PDF)
- Play the Administration Video
- Quick Reference Video: Understanding and Optimizing Use of the ILUVIEN Applicator
AccessPlus: Streamlined reimbursement support services
The ILUVIEN AccessPlus Program offers reimbursement support services with a streamlined process that is easily integrated into your patient processing system.
ILUVIEN AccessPlus supports your practice by offering comprehensive services built around your needs:
|To help you better understand|
your patient’s health plan coverage for ILUVIEN
|To provide guidance and assistance for patient|
|To help your patients with their out-of-pocket costs|
|To provide acquisition and
access options best suited for your patient and practice
The ILUVIEN AccessPlus program is easy:
- Prescribing physician enrolls one time with a simple, one-page Prescriber Enrollment Form
- One-page Patient Enrollment Form
- The enrollment form collects information needed for coverage coordination (benefits investigation, prior authorization, product acquisition options, financial assistance, claims support, and appeals support)
- You receive a Summary of Patient Benefits for each patient benefits investigation with detailed information on ILUVIEN coverage for your patient
ILUVIEN AccessPlus is available to you:
By Phone: 1-844-445-8843, Option 3
AccessPlus Case Managers are available
Monday – Friday, 8 AM EST – 6 PM EST
Online: www.ILUVIEN.com/AccessPlus ILUVIEN.com offers reimbursement resources including downloadable enrollment forms, coding and billing guidance, ordering and product replacement information, and more.
By Fax: 1-844-501-7161
In Person: Dedicated Reimbursement Account Specialists are available to you, in person or by phone, to provide information about our resources for and reimbursement of ILUVIEN.
Sample Forms and Letters
DocumentsDownload All Documents
ILUVIEN Continuous MicrodosingTM Delivery System
Quick Reference Video: Understanding and Optimizing Use of the ILUVIEN Applicator
Patients with a financial need have several options to help cover the cost of ILUVIEN (fluocinolone acetonide).
ILUVIEN CoPay Program:
Eligible patients who have commercial or private insurance may qualify for assistance with out-of-pocket costs for ILUVIEN.Download Brochure
No income eligibility requirement. No maximum assistance level.
The ILUVIEN CoPay Program provides assistance toward product-specific co-pay, co-insurance and insurance deductibles for ILUVIEN that exceed $25.
The patient is responsible for the first $25 of each treatment’s co-pay for ILUVIEN
- Patient must have commercial or private insurance that covers ILUVIEN for the FDA labeled indication
- Patient out-of-pocket cost for ILUVIEN must exceed $25
- Patient must provide household income and number in household
- Patient must be a resident of the United States
This program is not valid where prohibited by law, taxed or restricted. Alimera Sciences reserves the right to change or cancel this offer or eligibility terms at any time without notice.
ILUVIEN CoPay Program Enrollment Options
ILUVIEN Patient Enrollment Form: Enter patient’s household income and number in household information on Page 2 when enrolling a patient with AccessPlus.
Phone: Your office or the patient may call AccessPlus at 1.844.445.8843, Option 3 to enroll.
Co-pay Assistance - Referral to a Foundation:
For patients who may need assistance with the out-of-pocket costs for ILUVIEN, AccessPlus can assist with the referral and application process to an independent co-pay assistance foundation when ILUVIEN is prescriber per the FDA-labeled indication.
Co-pay assistance foundations are independent organizations. Eligibility criteria are set by the foundation. Alimera Sciences does not control or influence the operations and cannot guarantee assistance will be provided.
Process for referral to a foundation:
ILUVIEN Patient Enrollment Form, Page 2:
- Provide patient’s household income and number in household
- Enter preferred foundation
- Patient signs and dates “Applicant Authorization” section
- Fax completed ILUVIEN Patient Enrollment form to AccessPlus at 1.844.501.7161
AccessPlus completes a benefits investigation for ILUVIEN and determines if a patient out-of-pocket responsibility is expected.
If patient is insured by government-funded healthcare and is expected to have financial responsibility for ILUVIEN, AccessPlus will refer to the foundation of your choice and provide you with the application approval status and decision when available.
Independent Co-Pay Assistance Foundations with Macular Disease Funds:
|Foundation Name||Phone Number||Website||Hours of Operation|
(Chronic Disease Fund)
|(877)968-7233||www.mygooddays.org||Monday – Friday
8 am – 5 pm CST
|Patient||(888) 316-7263||www.panfoundation.org||Monday – Friday
9 am – 5 pm EST
ILUVIEN Patient Assistance Program (PAP):
Provides ILUVIEN free of charge to eligible patients who are uninsured or lack coverage for ILUVIEN.
- Uninsured or lacks coverage for ILUVIEN
- ILUVIEN must be prescribed per the FDA labeled indication.
- Patient must be a resident of the United States
- Patient must have a financial need
Based on total adjusted annual household income of $100,000 or less
Patient must complete ILUVIEN Patient Assistance Program Application to be considered for the program.
- Fax the completed and signed PAP application to AccessPlus at 1.844.501.7161
- The application will be reviewed and an approval decision will be made within 5 business days.
- The provider office and the patient will receive a letter with the approval status of the application.
- AccessPlus will coordinate shipment of PAP ILUVIEN to your office upon approval of the patient application.
How to Order ILUVIEN
To order ILUVIEN, contact your distributor today:
Besse Medical Ophthalmology
888.767.7123 | View Besse online catalog
ILUVIEN Order No. 44083
McKesson Specialty Health
855-477-9800 | View McKesson's Ophthalmology site
ILUVIEN Order No. 5004970
Product Return and Replacement:
Alimera Sciences will replace product that is not usable at no charge.
Contact AccessPlus at 1.844.445.8843, Option 4
AccessPlus will obtain the information needed to initiate the product replacement request.
You will return the unusable product to Alimera Sciences using the shipping label provided during the replacement request process.
*For return and replacement of expired product:
Complete the ILUVIEN Expired Product Replacement Request FormDownload Form
Fax or email the completed form to Alimera Sciences
Fax Number: 1.404.529.4676