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Simple facts about complex topics: cost and insurance

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Paying for your prescription

Paying for your prescription

Many questions can come up when it comes to affording medication. You might be wondering about NUPLAZID® (pimavanserin) commercial co-pay assistance, if Medicare covers NUPLAZID, or about financial assistance for patients with hallucinations and delusions associated with Parkinson’s disease psychosis.

Rest assured: there are options available that may help you cover the cost of NUPLAZID. We’ve got some answers right here on this page. We can provide you with information about a patient assistance program if you do not have insurance or your insurance does not cover NUPLAZID.

You can always call your Care Coordinator with questions, too.

This information is intended as a guide. Coverage and costs may differ between private and government insurance plans, and are subject to change. Please check with the health plan to confirm coverage for individual patients.

co-pay

$0 Co-pay for commercial insurance patients

The $0 co-pay is as simple as it sounds: you pay $0 for your NUPLAZID prescription. This may be available to patients who have commercial insurance. To see if you qualify, contact your Care Coordinator. 

What type of insurance do you have?

There are a few different types of coverage. See which applies to you. 


Government insurance

Government insurance

Government insurance includes Medicare info-iconMEDICARE: A government health plan for people aged 65 and older and/or people who are disabled.

MEDICARE PART D: The part of Medicare that covers prescription medication.
, Medicaid, and other government programs. The United States Department of Veterans Affairs (VA) and the Department of Defense (DoD) offer health plans for people who have served in the United States Armed Forces or those who worked for these agencies. 

Commercial insurance

Commercial insurance

Commercial insurance is health insurance you get through your work or a healthcare exchange. It’s also known as private insurance. Examples of private insurance companies include Aetna®, Cigna®, and Blue Cross® Blue Shield®

If you have commercial insurance that covers NUPLAZID with a co-pay or co-insurance, you’re eligible to get NUPLAZID for $0, no matter what your income is.

NUPLAZIDconnect patient eligibility and terms and conditions apply.

No insurance or underinsured 

No insurance or underinsured 

If you don’t have any insurance, you’re considered uninsured. If you have insurance but it doesn’t cover the cost of NUPLAZID, you’re considered underinsured. 

The good news is that in either case, you may be able to get NUPLAZID for $0 through the NUPLAZIDconnect Patient Assistance Program. Your Care Coordinator can check to see if you qualify based on your income and other eligibility guidelines. 

insurance coverage questions

Not sure about insurance coverage 

If you’re not sure what type of insurance coverage you have, your Care Coordinator can share tips for finding out. Typically, if you have coverage, you make monthly insurance payments, or they’re deducted from your paycheck. 

You may want to check with your doctor’s office, medical group, or pharmacy; they often have information on file. You’ll also need to check if it’s current. 

What’s your insurance coverage?

What’s your insurance coverage?

Use our simple tool to find out if your current insurance covers the monthly cost of your NUPLAZID prescription. You can also discover possible options for financial assistance. 

glossary of insurance terms

A handy glossary of insurance terms  

CO-INSURANCE:

The percentage of a drug cost that you pay. Your insurance company pays the rest.

CO-PAY:

A fixed dollar amount you pay for a drug. Your insurance company pays the rest.

COMMERCIAL INSURANCE:

This is health insurance you get through your work or a healthcare exchange. It’s also known as private insurance. Examples of private insurance companies include Aetna®, Cigna®, and Blue Cross® Blue Shield®

DEDUCTIBLE:

The amount you pay for healthcare services before your insurance company begins to pay.

MEDICARE:

A government health plan for people aged 65 and older and/or people who are disabled.

MEDICARE PART D:

The part of Medicare that covers prescription medication.

OUT-OF-POCKET DRUG COSTS:

Drug costs that are not covered by your insurance company.

SPECIALTY PHARMACY:

Companies that deliver drugs directly to your home and offer services to help you stay on your medications.

UNINSURED:

A person who does not have any insurance coverage.

UNDERINSURED:

A person who has insurance, but NUPLAZID is not covered.

VA/DoD:

The United States Department of Veterans Affairs (VA) and the Department of Defense (DoD) offer health plans for people who have served in the United States Armed Forces or those who worked for these agencies.

Questions about NUPLAZIDconnectTM ?

Give us a call.

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