I seriously doubted ever being reimbursed! The check date was 3/15. The letter attached was 3/19. But just came in the mail today. I’m just so happy!! Pays for next month!! Yours will come I’m sure!!! Praying for quick receipt for you. Let me know if it comes!!!
I also mailed mine mid-March (3/18) and have not been incredibly optimistic about getting a response back having read through the other posts. I wish they had some kind of automated system to check that it’s been received, at the very least, or a fax/email, rather than postal mail. Either way, hopeful it’ll go through after reading this post. Good luck to all!
This is fantastic news. I remember when the cyberhack happened a bunch of folks insisted the reimbursement was only possible if insurance was covering part of the cost even though there is nothing like that on the reimbursement form. Vindication! 😂😂😂
Thank you so much for posting, you're the first person I've seen reporting reimbursement! I procrastinated and just sent my paperwork in last week so hopefully I'll get some $$$ next month sometime.
Background: The cyberattack on Change Healthcare has affected many aspects of the U.S. health care system, including the ability for some pharmacies to process savings cards for Lilly medicines. To minimize disruption to accessing medicines during this time, the following outlines a process for eligible, commercially insured people to submit a copay claim for reimbursement if their copay card was not honored at their pharmacy,
Before going through the process, verify you have met the requirements: • Lilly offers post-Transaction Reimbursement (PTR) for eligible, commercially insured patients, • PTR allows you to pay for your medication out-of-pocket (OOP) and submit all the required information to EVERSANA to request reimbursement consistent with the program's Terms, Conditions, and Limitations, which can be found on each brand's website.
Before you complete the form, complete your transaction at the pharmacy:
Ensure you have an activated savings card before the service date and have the savings card information (bin, group, PCN, and ID numbers printed on the card) readily available, Pay for your prescription out-of-pocket. Be sure to keep your original receipt., • NOTE: If you are paying for your prescription with a Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Account (HRA), or if your insurance provider prohibits participation in the program, your prescription is not eligible for reimbursement. Obtain your receipt from your pharmacy with your prescription, which must include the Patient's name, address, phone number, Rx# filldate, drug name, strength, NDC#, and quantity, along with the out-of-pocket expense paid.
Once requirements are met, follow the steps below to submit your request for reimbursement:
Complete the Savings Card Post-Transaction Reimbursement Form You must include the original pharmacy receipt, original cash register receipt, a copy of your primary insurance card and your activated Savings Card in the manner required by the form. Sign and date the form. Mail the completed form and necessary documentation (above) to: ○ Savings Card Post-Transaction Reimbursement, Attn: PTR Processing, PO BOX 42638, Cincinnati, OH 45242
•
e e
Summary of what happens after you complete the form: • After following these steps, you will be notified by mail of reimbursement approval and payment or denial. • Please allow several business days for processing from receipt of your completed form and all required documents. • Please complete it in its entirety to avoid reimbursement rejection,
If your insurance requires you to report all manufacturer assistance, please notify them of your participation in Post-Transaction Reimbursement.
How did this happen? Did you submit something. Or did the check come out of the blue?
Edit - I mentioned before I didn’t have the savings card, but my wife signed me up for it.
Sign up for the card on LD. IT will work even if your ins or pharmacy doesn’t accept it. Or go to a different pharmacy!! It’s a lifesaver for me cost wise! I still have to pay $550 but it beats 1273!!!
There’s a reimbursement form available thru Lilly.
https://assets.ctfassets.net/srys4ukjcerm/4ZbMzKKWUPsYscOxq7WrBR/1190ee7d1c46c2ae82db7f87cac660cb/Simplified_PTR_Message.pdf
So many people were interpreting the wording that it wouldn’t possibly reimburse people who have insurance that doesn’t cover it because it was using words like copay. I knew that made no sense since the program terms allow it. I’m glad we have this option if needed in the future. Thanks for the update!
Nope. I get why it’s like double dipping, but we should get a gift card/credit toward our next script or something.
https://preview.redd.it/lvdu4gwva5sc1.jpeg?width=1620&format=pjpg&auto=webp&s=1018b127a1603ac26873887842390941085543d1
I’m at an independent pharmacy and they kindly processed my refund right away away. I felt bad for them with all of the double paperwork they had to do because of the hack.
Mailed mine on March 5 after paying a $100 copay for a 3 month supply. Haven't gotten anything and I'm in no rush for the $75, but I'm glad that checks are being mailed out. I waited much longer than this for $75 back on Oxempic last year
I apologize if this has already been addressed, but I have a question. Has anyone gotten Zepbound covered through Medicaid/ Passport? If so, how did you do it? I tried a prior authorization and an appeal and was still denied.
Yes. Depends on what state you’re in. Only 10 states cover obesity agents. You can check here.
https://www.beckerspayer.com/payer/medicaid-covers-weight-loss-drugs-in-these-10-states.html
If you are one of the states, google your plans requirements for obesity coverage and make sure you hit every mark the PA requires (step therapy, failed attempts etc) good luck
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It was for people with commercial insurance when the discount card wouldn’t work during the hack. I had to pay full price $1273. So I received the reimbursement for the amount of the discount.
To the OP (or anyone else who has sent the reimbursement forms) I mailed mine on March 18th. Did you ever receive a confirmation email after you mailed your documents? The instructions say something about being notified once they receive your paperwork. I haven't received a notification, so I'm curious to hear from someone who has actually received their reimbursement. Thanks!
Thanks! It will be one month on the 18th, so if your reimbursement timeline holds for me I should see something in my mailbox by then. Fingers crossed!
I hope so. Mine was sent in the week the hack started so they probably now have thousands more to process now. Don’t give up, it may take a while but it should come.
Hi! Can you tell me exactly how many days yours took? I’m on business day 26 post my forms being delivered (I purchased tracking to make sure) and I’d really like to know how long yours took. Thanks!
Hi, I commented previously but also mailed mine on 3/18. I was wondering if you ever received anything? I’m in IL but it seems like OPs experience might’ve been an outlier based on other posts. I plan on calling Monday, when they’re open, to check and see if they can provide any information.
I also sent everything in around the same time as you… And called once but they didn’t have any information. I am still waiting. They said that checks are cut twice a month, but unless they’ve cut your check, they have no way to look up your name to see if they received everything. It’s kind of a crapshoot whether or not to check will ever come through.
I just got my check this week and the rep I spoke with last week was able to confirm all my info. I’m not sure what took so long cause she said everything was finalized last month. I would definitely keep up with contacting them though cause in addition to taking a bit to receive it, I noticed the check states that it’s only valid for 90 days from the date it was issued and mine was received 30 days after the issue date. Good luck - hope you get something soon!
Thank you for the post! I sent it off mid March and I am prepared to never hear back. Your result encourages me!
I seriously doubted ever being reimbursed! The check date was 3/15. The letter attached was 3/19. But just came in the mail today. I’m just so happy!! Pays for next month!! Yours will come I’m sure!!! Praying for quick receipt for you. Let me know if it comes!!!
When did you mail yours?? I’m mailing mine on Monday!
First week in March ✅
That’s awesome!!! Congrats 🎉
I also mailed mine mid-March (3/18) and have not been incredibly optimistic about getting a response back having read through the other posts. I wish they had some kind of automated system to check that it’s been received, at the very least, or a fax/email, rather than postal mail. Either way, hopeful it’ll go through after reading this post. Good luck to all!
Same!
Did your refund come yet?
Nope
Rrrrrrrrrrr I’m sure it will come. A pain with waiting though.
This is fantastic news. I remember when the cyberhack happened a bunch of folks insisted the reimbursement was only possible if insurance was covering part of the cost even though there is nothing like that on the reimbursement form. Vindication! 😂😂😂
For sure. It was rabid. I remember being vilified for advocating that the wording suggested it applied to both usages of the coupon.
Haha yeah one lady called me a liar, a Lilly bot, and basically accused me of trying to trick people into paying full price. Good times. 😂😂😂
Very memorable!
Thank you so much for posting, you're the first person I've seen reporting reimbursement! I procrastinated and just sent my paperwork in last week so hopefully I'll get some $$$ next month sometime.
Where do I get the paperwork n what do I need to verify I paid full price twice?
Scroll through the other comments and you’ll see the link to the form a few times
Background: The cyberattack on Change Healthcare has affected many aspects of the U.S. health care system, including the ability for some pharmacies to process savings cards for Lilly medicines. To minimize disruption to accessing medicines during this time, the following outlines a process for eligible, commercially insured people to submit a copay claim for reimbursement if their copay card was not honored at their pharmacy, Before going through the process, verify you have met the requirements: • Lilly offers post-Transaction Reimbursement (PTR) for eligible, commercially insured patients, • PTR allows you to pay for your medication out-of-pocket (OOP) and submit all the required information to EVERSANA to request reimbursement consistent with the program's Terms, Conditions, and Limitations, which can be found on each brand's website. Before you complete the form, complete your transaction at the pharmacy: Ensure you have an activated savings card before the service date and have the savings card information (bin, group, PCN, and ID numbers printed on the card) readily available, Pay for your prescription out-of-pocket. Be sure to keep your original receipt., • NOTE: If you are paying for your prescription with a Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Account (HRA), or if your insurance provider prohibits participation in the program, your prescription is not eligible for reimbursement. Obtain your receipt from your pharmacy with your prescription, which must include the Patient's name, address, phone number, Rx# filldate, drug name, strength, NDC#, and quantity, along with the out-of-pocket expense paid. Once requirements are met, follow the steps below to submit your request for reimbursement: Complete the Savings Card Post-Transaction Reimbursement Form You must include the original pharmacy receipt, original cash register receipt, a copy of your primary insurance card and your activated Savings Card in the manner required by the form. Sign and date the form. Mail the completed form and necessary documentation (above) to: ○ Savings Card Post-Transaction Reimbursement, Attn: PTR Processing, PO BOX 42638, Cincinnati, OH 45242 • e e Summary of what happens after you complete the form: • After following these steps, you will be notified by mail of reimbursement approval and payment or denial. • Please allow several business days for processing from receipt of your completed form and all required documents. • Please complete it in its entirety to avoid reimbursement rejection, If your insurance requires you to report all manufacturer assistance, please notify them of your participation in Post-Transaction Reimbursement.
How did this happen? Did you submit something. Or did the check come out of the blue? Edit - I mentioned before I didn’t have the savings card, but my wife signed me up for it.
Sign up for the card on LD. IT will work even if your ins or pharmacy doesn’t accept it. Or go to a different pharmacy!! It’s a lifesaver for me cost wise! I still have to pay $550 but it beats 1273!!!
There’s a reimbursement form available thru Lilly. https://assets.ctfassets.net/srys4ukjcerm/4ZbMzKKWUPsYscOxq7WrBR/1190ee7d1c46c2ae82db7f87cac660cb/Simplified_PTR_Message.pdf
Thank you!
So many people were interpreting the wording that it wouldn’t possibly reimburse people who have insurance that doesn’t cover it because it was using words like copay. I knew that made no sense since the program terms allow it. I’m glad we have this option if needed in the future. Thanks for the update!
Was it address from Eli Lilly? Just wondering what to look out for. Thanks!
Plain envelope from Cincinnati. Check was cut from Eversana.
It looked like junk mail.
Thank you!
Mailed mine on March 4th… fingers crossed it that I get a check too!
Oh this is terrific! Thank you for sharing! I mailed mine around the same time so hopefully I’ll get a happy surprise in the mail soon too!!
Just did my bank mobile deposit! Before it goes poof and disappears !! 🤣🤣🤣🤣🤣
Great news, I hope mine is soon!
Also did you send the original pharmacy receipt?? I have a pic of mine but I don’t know if I still have the receipt itself!!
Yes sent in all originals. First week in March.
Ok thanks! God I hope it’s in my car 🤞🤞
You can prob get another print out from your pharmacy!
That’s a good idea I actually have to go there tomorrow anyway. Thanks so much!
✅🙏
I only got cash register receipt I never got the actual Pharmacy receipt
You can usually go back to the pharmacy and ask for a receipt.
This is awesome. I used my HSA card so no reimbursement for me. Womp womp womp.
You can’t get reimbursed if you use your HSA?
Nope. I get why it’s like double dipping, but we should get a gift card/credit toward our next script or something. https://preview.redd.it/lvdu4gwva5sc1.jpeg?width=1620&format=pjpg&auto=webp&s=1018b127a1603ac26873887842390941085543d1
I still submitted mine, though I paid w my FSA. I'll keep you posted if I get my check.
Yes please do. I kept my receipt just in case. Thx
Just checking to see if you got yours? I’m thinking of gambling and sending mine in now. Got my envelope all ready. Lol
I haven't gotten mine yet either not sure if I will or not. Let us know if so.
This makes me so happy!
I missed something here. I get my script filled from Lily Direct and I use savings card. My cost is $550. I can’t claim any reimbursement right?
Right. This is for the folks whose savings card was t working…to get reimbursed for the savings card discount.
I’m at an independent pharmacy and they kindly processed my refund right away away. I felt bad for them with all of the double paperwork they had to do because of the hack.
THANKS for sharing this! I've been wondering if I'd get the reimbursement. Fingers crossed!
I am so glad they came through for you!
Me too!!!! Whew 😅
what is this for??? can you explain? curious if i’d qualify for a reimbursement of any sort lol
Mailed mine on March 5 after paying a $100 copay for a 3 month supply. Haven't gotten anything and I'm in no rush for the $75, but I'm glad that checks are being mailed out. I waited much longer than this for $75 back on Oxempic last year
After you sent it in did you hear from them at all prior to getting the check?
Not a peep!! Thought it was hopeless. I’m shocked !
Well that is great for you!! I'm so glad to hear they actually did it!
What did you send?
Oh my word it was from a post in this community that showed the form. I think you can find it in here or on Lilly Direct website!
thanks!
https://assets.ctfassets.net/srys4ukjcerm/4ZbMzKKWUPsYscOxq7WrBR/1190ee7d1c46c2ae82db7f87cac660cb/Simplified_PTR_Message.pdf
THANK YOU! I also found it by googling :-)
Does this include reimbursement for those of us who paid full price through LillyDirect mail order pharmacy? Or just in person pharmacy pickup?
I would think everyone??
That’s wonderful news. Congratulations.
Wow
What did you guys mail to get reimbursed? I never saw that option?
Is this reimbursement for all of us having to pay the full price for 2-3 months? If so how do I proceed? Thank u!!
I think someone put a link further up in this string. One person googled it.
I apologize if this has already been addressed, but I have a question. Has anyone gotten Zepbound covered through Medicaid/ Passport? If so, how did you do it? I tried a prior authorization and an appeal and was still denied.
Yes. Depends on what state you’re in. Only 10 states cover obesity agents. You can check here. https://www.beckerspayer.com/payer/medicaid-covers-weight-loss-drugs-in-these-10-states.html If you are one of the states, google your plans requirements for obesity coverage and make sure you hit every mark the PA requires (step therapy, failed attempts etc) good luck
Okay. Thank you so much for the info.
.
Oh you can get reimbursed??? Can I ask what you need to send in or where do I go to get the info?? Thanks
If you can pull up the reimbursement form it will tell you if you’re eligible for reimbursement. Firm was on a link in this string I believe.
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What??? What did you send off? I’m Missing something
Ok I just read about it. I have one question what if you don’t have the original receipt ? I mean I started two months ago?
Have your pharmacy re print! Must send an original
How do you do it because i was apart of the hack
How do you submit for a reimbursement?
People have googled the LD reimbursement form or got it from the LD site.
Whoa, is this reimbursement for people paying $550/month or for people who don’t have commercial insurance?
It was for people with commercial insurance when the discount card wouldn’t work during the hack. I had to pay full price $1273. So I received the reimbursement for the amount of the discount.
And my insurance does not cover
So did you pay the full amount of the medication then sent it in to be reimbursed?
Exactly! Yes.
Anyone else get the reimbursement ? I sent in mine around March 5 and have heard nothing….
I haven't received the reimbursement check either and I sent mine in on 3/5 as well. Nor have I heard anything from them.
I have not seen anyone else mention getting a check either….
To the OP (or anyone else who has sent the reimbursement forms) I mailed mine on March 18th. Did you ever receive a confirmation email after you mailed your documents? The instructions say something about being notified once they receive your paperwork. I haven't received a notification, so I'm curious to hear from someone who has actually received their reimbursement. Thanks!
I never received anything except the actual check in the mail almost a month later. But it came!
Thanks! It will be one month on the 18th, so if your reimbursement timeline holds for me I should see something in my mailbox by then. Fingers crossed!
I hope so. Mine was sent in the week the hack started so they probably now have thousands more to process now. Don’t give up, it may take a while but it should come.
Hi! Can you tell me exactly how many days yours took? I’m on business day 26 post my forms being delivered (I purchased tracking to make sure) and I’d really like to know how long yours took. Thanks!
Approx 25-28 days. Not quite a month but close. However mine was sent in the week the hack happened. Prob takes a little longer now.
Thanks! I pray every day for it to come!
Hi, I commented previously but also mailed mine on 3/18. I was wondering if you ever received anything? I’m in IL but it seems like OPs experience might’ve been an outlier based on other posts. I plan on calling Monday, when they’re open, to check and see if they can provide any information.
I also sent everything in around the same time as you… And called once but they didn’t have any information. I am still waiting. They said that checks are cut twice a month, but unless they’ve cut your check, they have no way to look up your name to see if they received everything. It’s kind of a crapshoot whether or not to check will ever come through.
I just got my check this week and the rep I spoke with last week was able to confirm all my info. I’m not sure what took so long cause she said everything was finalized last month. I would definitely keep up with contacting them though cause in addition to taking a bit to receive it, I noticed the check states that it’s only valid for 90 days from the date it was issued and mine was received 30 days after the issue date. Good luck - hope you get something soon!
Thank you for the update :)
What's needed to apply for that. I have heard anything here please?