Insurance Coverage
You may call the Synvisc® / Synvisc-One® HELPLINE
at 1-800-796-7991 Our specialists will be happy to help you and provide answers to most questions you may have.
Most private insurance companies cover Synvisc® and Synvisc-One® when used for their authorized indications. However, not all insurers and plans reimburse the same amount. Benefits vary according to the specific plan under which you're covered.
What are Synvisc® or Synvisc-One® pseudo–Drug Identification coverage numbers
Je suggere ajouter une icone de PDF pour - PDF with pseudo-Drug Identification Numbers
- Drug Benefits section
- Extended Health Benefits section under Medical Services & Supplies.
- If you have a flexible* benefit plan, you might have “flex credits” or “health points” in your account insurance that could be used to cover most health-related expenses, like Synvisc® or Synvisc-One® injections.
- Specific name of the product – Synvisc® or Synvisc-One®, or
- Type ”viscosupplements” or ”viscosupplementation”
- Any yearly or lifetime maximum?
- Any specific requirements?
Examples:- Must have a written prescription
- Must be dispensed from a pharmacy
- Must be prescribed by a specialist MD
Each insurance plan is different. It is your employer’s decision whether to include coverage for Synvisc® or Synvisc-One®.
Coverage information can be found in your employee benefits booklet, website or app under the:
*Some employers offer their employees a flexible benefits program which tailors benefits packages based on individual and family needs. A flexible benefits program lets each employee choose from a range of benefit options to better meet their respective health needs.
Navigating your insurance plan and coverage can be difficult. Your plan might change depending on your employer, the insurance company administrating the plan and the plan you have chosen to opt into. Moreover, you may already be covered under your spouse’s insurance plan.
Look for the language below for coverage options by:
The level of coverage, such as yearly or lifetime maximums, and/or requirements, such as ”must have a written prescription” or ”must be dispensed by pharmacy”, may also be found within these sections.
Unlike prescription medications you might have taken before, Synvisc®/Synvisc-One® are classified as Medical Devices by Health Canada, not medications.
To simplify your search, you may call your insurance company and use the following pseudo–Drug Identification Numbers (DIN) we have created with most insurance company to access coverage information.
[Link to PDF with pseudo–Drug Identification Numbers]
You could also ask your pharmacist to run a test claim in their system, using a pseudo–DIN, to see if it’s covered.
Ask them about your level of coverage:
At the pharmacy
Some insurers allow Synvisc®/ Synvisc-One® products coverage to be processed directly at the pharmacy. With the use of your drug card, the pharmacy can process the claim electronically using the appropriate identification number for your employer’s drug benefits plan.
Pay and then submit the receipt
Some insurers require you to pay for the product and then submit the receipt and claim form to your insurance company. Including the identification number may also be useful for such manual claims. Tip: Since many clinics sell Synvisc®/ Synvisc-One® to their patients just before their injection for convenience, always check with your insurance company first if there are any restrictions regarding where you purchase Synvisc®/ Synvisc-One®.
Our Benefit Verification Specialists are available to help patients navigate their unique coverage situation for Synvisc®/Synvisc-One®. You should be able to obtain details on the status of your insurance benefits for Synvisc®/Synvisc-One®.
Our specialists can:
- Help you verify your insurance benefits and navigate coverage options based on your specific plan(s)
- Offer you tips on how to appeal for coverage with your employer
Our Benefit Verification Specialists are experts in finding available insurance coverage. They have many years of experience and they answer calls from people considering Synvisc®/Synvisc-One® or people who have purchased Synvisc®/Synvisc-One® and need help navigating their coverage options.