Resources to Help Your Patients
ClickTap on each of the options to learn more.
J&J withMe provides you with access, affordability, and treatment support for your patients
Access support to navigate the prior authorization (PA) process
Johnson & Johnson can provide PA support through CoverMyMeds®, a third-party service provider, to help your patients get started on INVEGA SUSTENNA®, INVEGA TRINZA®, or INVEGA HAFYERA®.
CoverMyMeds® is a no-cost solution that automates the process providers and pharmacists use for PA requests to help patients access their treatment with:
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- A streamlined process for submitting PA requests
- Faster PA determinations, compared to phone or fax, and often in real time
Johnson & Johnson is in a commercial relationship with CoverMyMeds®, providing PA support for J&J’s LAIs, including:
- Automatic renewal of previously submitted PA requests, where available
- Automatic notification to patients of PA determination with patient consent
For information on CoverMyMeds®,
call 866-452-5017866-452-5017, Monday–Friday,
8:00 AM–11:00 PM ET, and Saturday, 8:00
AM–6:00 PM ET, or visit
CoverMyMeds.com.
CoverMyMeds® is a registered trademark of CoverMyMeds® LLC. All rights reserved.
What you need to know about billing and coding for PA
The table below lists ICD-10 diagnosis codes that you may need for patients treated with J&J's LAIs. These codes are not intended to be promotional or to suggest a use that is inconsistent with FDA-approved use. The list is not exhaustive, and additional codes may apply. ICD-10 codes use 3 to 7 alpha and numeric characters. A code is invalid if it does not use the full number of characters required, including the seventh character, if applicable.
Schizophrenia (INVEGA SUSTENNA®, INVEGA TRINZA®, or INVEGA HAFYERA®)
| ICD-10 Indication | ICD-10 Code |
|---|---|
| Paranoid schizophrenia | F20.0 |
| Paraphrenic schizophrenia | |
| Disorganized schizophrenia | F20.1 |
| Hebephrenic schizophrenia | |
| Hebephrenia | |
| Catatonic schizophrenia | F20.2 |
| Schizophrenic catalepsy | |
| Schizophrenic catatonia | |
| Schizophrenic flexibilitas cerea | |
| Undifferentiated schizophrenia | F20.3 |
| Atypical schizophrenia | |
| Residual schizophrenia | F20.5 |
| Restzustand (schizophrenic) | |
| Schizophrenic residual state | |
| Other schizophrenia | F20.8 |
| Schizophrenia, unspecified | F20.9 |
Schizoaffective Disorders (INVEGA SUSTENNA® ONLY)
| ICD-10 Indication | ICD-10 Code |
|---|---|
| Schizoaffective disorder, bipolar type | F25.0 |
| Cyclic schizophrenia | |
| Schizoaffective disorder, manic type | |
| Schizoaffective disorder, mixed type | |
| Schizoaffective psychosis, bipolar type | |
| Schizoaffective disorder, depressive type | F25.1 |
| Schizoaffective psychosis, depressive type | |
| Schizoaffective disorder, unspecified | F25.9 |
See how J&J withMe can help your patients pay for treatment
No matter what type of healthcare coverage your patients have—or even if they don’t have insurance—J&J withMe can help find programs that may help pay for INVEGA SUSTENNA®, INVEGA TRINZA®, or INVEGA HAFYERA®.
For your patients enrolled in government-funded healthcare programs (Medicare, Medicaid, Military) or without insurance coverage
If your patients are enrolled in Medicare or have limited income, here are some key programs they may qualify for:
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- If your patients are enrolled in a Medicare Prescription Drug Plan, Medicare Part D Low-Income Subsidy, also called Extra Help, allows low or no prescription co-pays with no monthly premium, no deductible, and no gap in coverage. To qualify, patients must have limited income and resources
- State-sponsored programs may be available for patients with limited income and resources to help cover prescription costs or Medicare premiums, deductibles, or co-insurance. Find out if your patients’ state has a program that can help
- Medicaid provides free or low-cost health coverage to eligible patients. Certain states have even expanded their Medicaid programs to cover people with incomes below a certain level
- Independent foundations* that may help patients with co-pay assistance
*Independent co-pay assistance foundations have their own rules for eligibility, which are subject to change. We have no control over these independent foundations and can only refer your patients to a foundation that supports their disease state. We do not endorse any particular foundation.
The J&J withMe Savings Program can help eligible patients using commercial or private insurance save on out-of-pocket costs for J&J's LAIs. Depending on the patient’s health insurance plan, savings may apply toward co-pay, co-insurance, or deductible.
Your eligible patients will pay as little as $10 per treatment.
Maximum program benefit per calendar year shall apply. Not valid for patients using Medicare, Medicaid, or other government-funded programs to pay for their medicines. Terms expire at the end of each calendar year. Offer subject to change or end without notice. Program does not cover the cost to give patients their injections. Patients may participate without sharing their income information.
See program requirements.
Online enrollment of patients in the Savings Program by you, the pharmacy, patient, or caregiver
- Providers and pharmacies can use Express Enrollment for the Savings Program
- Patients and caregivers can enroll at
Account.JNJwithMe.com/express
Find support for your patients’ treatment with one of J&J’s LAIs
We understand that you want to ensure your patients have everything they need while going through treatment. That’s why we’ve put together some resources that can support them, whether they’re just starting a new treatment, or they’ve been receiving it for some time.
Your patients can get help finding locations to receive treatment by visiting
J&J’s LAIs Site Locator.†
Find out how you can request to register your pharmacy or clinical location to be listed in J&J’s LAIs Site Locator.
See Terms of Participation.
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†The inclusion of an injection site in the locator tool does not represent an endorsement from Johnson & Johnson. The locator tool is for informational purposes only. All users agree that use of the locator tool is at their own risk.
We are here throughout your patients’ journey
Staying on track with treatment can sometimes be difficult for patients, but it is important for patients to stay positive and find the support they need. The following tips can help:
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Need help? Call us at 877-227-3728877-227-3728, Monday–Friday, 8:00 AM–8:00 PM ET. Visit JNJwithMe.com.
The patient support and resources provided by J&J withMe are not intended to give medical advice, replace a treatment plan from the patient’s healthcare provider, offer services that would normally be performed by the provider’s office, or serve as a reason to prescribe INVEGA SUSTENNA®, INVEGA TRINZA®, or INVEGA HAFYERA®.
