What is Covered
Plans vary depending on different insurance companies and individual plans.
To determine if the insurance company will cover these medications, the patient should provide their insurance company with the appropriate drug identification number(s) (DIN).
Open List of Drug Identification Numbers
Extent of Coverage
The extent of coverage for the cost of medications used in GN will be determined by the insurance company.
Generic versions are available for most medications. Generic alternatives are generally the lowest cost alternatives that are covered by insurance plans. Brand name versions may only be funded if no generic alternative is available.
Patients should check with the insurance company to see if there is a yearly maximum amount for drug coverage and/or a lifetime maximum for coverage and any deductable costs before starting medication therapy.
In some cases, special authorization will be required by the private insurance company to obtain coverage of medications used for glomerular disease. In these cases, the kidney specialist must complete a special authorization form specific to the insurance company, detailing the diagnosis and explaining why the drug is needed. It is important to provide all clinical information so the private insurance company can make a decision about the drug coverage.
Patients should follow up directly with their private insurance program about response to special authorization requests and inform their medical team of the result, as the insurance company will directly contact the patient, not the care provider.
Disclaimer: The information contained herein (“Information”) is intended for informational purposes only, and no warranty as to its accuracy is provided or implied. The Information was collected from third party sources and is subject to change without notice. Cancer Care Ontario (CCO) makes no warranty that the Information is current. The Information is intended for use by healthcare professionals to advise patients of drug funding options that may be available to them. Do not act or rely upon the Information without exercising your independent judgment or seeking the advice of a qualified professional. Anyone using the Information does so at his or her own risk. The drug funding options described on this website are managed and funded by third parties, not by CCO. Please direct any inquiries to the applicable agency/entity who manages the drug funding option.