PROVENGE Financial Coverage

75% of patients receiving PROVENGE are expected to have minimal to no out-of-pocket costs

PROVENGE is covered by Medicare as well as most other commercial plans.

There are many types of insurance, so be sure to speak with your doctor’s office. You can also get more information about your coverage, as well as whether you are eligible for additional financial support during treatment with PROVENGE, by calling 1-877-336-3736.

Coverage information is current as of June 2012. Your insurance coverage will be dependent upon several factors such as where you live and your health plan’s insurance benefit design. Please contact 1-877-336-3736 or your plan administrator for more information.

Our commitment to patients with limited financial resources

Dendreon wants to make sure help is available for patients who need financial assistance.

Patient assistance programs include:

PROvide—A new patient assistance program for patients with commercial insurance. PROvide supports eligible patients by covering any combination of cost—co-pays, co-insurance, or deductible costs—to a maximum of $6,000 over the 3 PROVENGE treatments*
Co-pay Assistance for Patients With Medicare—Help with co-pays, co-insurance, and deductible costs for eligible patients^†
Support for Patients Without Coverage for PROVENGE—Eligible patients may be able to get PROVENGE free of cost through the PROVENGE Uninsured Patient Program*
Travel Cost Assistance—Help with treatment-related travel costs for eligible patients^†

For more information, please call 1-877-336-3736.

*PROvide, the commercial copay card program, and the Uninsured Patient Program eligibility criteria can be changed or program can be discontinued at any time at the sole discretion of Dendreon, the maker of PROVENGE.

^†Co-pay and travel assistance foundations provide assistance regardless of the choice of medicine, and decisions are based on financial need and according to criteria established by individual foundations. Dendreon can assist patients by referring them to these independent organizations. Dendreon cannot guarantee that patients will be eligible for or receive assistance after referral. Dendreon does not have controlling or managerial influence on these independent organizations.

Support

Will My Insurance Provider Cover PROVENGE (sipuleucel-T)?

Select your primary insurance provider to determine if you have coverage for PROVENGE:

	Medicare You receive benefits directly from Medicare
	Medicare Advantage You receive Medicare benefits through a private health plan
	Commercial/Private Insurance You participate in a benefit plan sponsored by an employer, professional association, or company (e.g. retiree benefit)
	Medicaid You receive benefits through a state-administered program available only to certain low-income individuals and families
	No Coverage for PROVENGE

If your Primary Insurance is Medicare then:

PROVENGE is administered in the physician office as a Medicare Part B drug. Therefore, you do not need a Medicare Part D drug benefit to access PROVENGE.

Do you have any other insurance IN ADDITION to Medicare?
Supplemental insurance is additional insurance that you can purchase to help you pay for services and expenses that your standard Medicare benefit does not cover.

Please click an option below that best fits your secondary insurance coverage:

	Commercial/Private Insurance You participate in a benefit plan sponsored by an employer, professional association, or company (eg retiree benefit)
	Medicaid You participate in a state administered program available only to certain low-income individuals and families
	No Other Insurance You have Medicare coverage, but no additional insurance

If your Primary Insurance is Medicare and,
you also have Commercial Supplemental then:

All Medicare Administrative Contractor regions are required to cover PROVENGE based on the FDA-approved label per the National Coverage Determination (NCD).

The majority of patients with Medicare plus a supplemental insurance will have no patient out-of-pocket costs
Medicare pays for 80% of drug and procedure costs
Commercial plan pays some or all 20% of the remaining cost share
Call Dendreon ON Call to learn about independent patient assistance foundations to help you with remaining copay or treatment-related travel costs

If your Primary Insurance is Medicare and,
you also have Medicaid Supplemental then:

All Medicare Administrative Contractor regions are required to cover PROVENGE based on the FDA-approved label per the National Coverage Determination (NCD).

The majority of patients with Medicare plus a supplemental insurance will have no patient out-of-pocket costs
Medicaid pays for some or all of the 20%; Coverage and cost share vary by state
Copays typically range from $5 to $50 but may vary by state
Call Dendreon ON Call to connect with independent patient assistance foundations to help you with remaining copay or treatment-related travel costs

If your Primary Insurance is Medicare then:

All Medicare Administrative Contractor regions are required to cover PROVENGE based on the FDA-approved label per the National Coverage Determination (NCD)

Medicare pays for 80% of drug and procedure costs
Patient is responsible for remainder
Call Dendreon ON Call to learn about independent patient assistance foundations to help patients with copays or treatment-related travel costs

If your Primary Insurance is Medicare Advantage then:

Medicare Advantage plans (choosing to receive your Medicare benefits through a private health plan) pay for 80% to 100% of drug and procedure costs; the percentage may vary by plan
Call Dendreon ON Call to learn about independent patient assistance foundations to help you with copays or treatment-related travel costs

If your Primary Insurance is Commercial/Private Insurance then:

Coverage and cost share may vary by health plan
Call Dendreon ON Call to learn about coverage in your state and to connect with independent patient assistance foundations to help you with copay and treatment-related travel costs

Review health plan coverage policies in your state by choosing the state you live in.

If your Primary Insurance is Medicaid then:

Coverage and cost share may vary by state
Copays typically range from $5 to $50 but may vary by state
Call Dendreon ON Call to learn about coverage from your health plan and to connect with independent patient assistance foundations to help you with copay and treatment-related travel costs

If you do not have any insurance to cover PROVENGE

For eligible patients who do not have coverage for PROVENGE, Dendreon, the maker of PROVENGE, provides PROVENGE free of cost*
In the event your claim for coverage for PROVENGE is denied by your payer after all appeals, the cost of the drug may be covered by Dendreon's patient assistance program
Eligibility criteria include:
- A household adjusted gross income of $150,000 or less
- United States residence
- On-label prescription for PROVENGE
Call Dendreon ON Call to learn about coverage from your health plan and to connect with independent patient assistance foundations to help you with copay and treatment-related travel costs

*The eligibility criteria for the assistance program for patients with no health insurance can be changed or the program can be discontinued at any time at the sole discretion of Dendreon.

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Call 1-877-336-3736 if you have
questions concerning your insurance coverage

Get the Support You Need