Advocacy in Action: Preparing for Re-enrollment Season in Patient Assistance Programs

For many people, November reminds us of fall leaves, great holiday food and all we must be thankful for. For patients struggling with high-cost infusions, and the Patient Advocates who support them, it’s a different reminder.

“Re-enrollment Season” is what we refer to as the time of year – typically October through the end of January – where patients and Patient Advocates are tirelessly gathering medication orders, signatures and supporting financial documents to maintain enrollment into philanthropic aid programs that cover some of their out-of-pocket expenses during the new year. Many popular free medication assistance programs have enrollment periods which end on December 31^st each year. As a result, patients or advocates on their behalf will need to complete the re-enrollment process at the end of every calendar year. Not having the right process in place can cause delays in program approval – and may ultimately result in patient treatment delays.  

The key to a successful re-enrollment season is being prepared, below are tips for the re-enrollment season.

1. Invest in a tech platform that automates all of this and the entire submission process. Utilize a solution with features such as enrollment and expiration date tracking, a PDF application database, electronic document and signature retrieval tools, e-fax ability, etc., to streamline the entire process. This will help improve the award rates for patients and win re-enrollment season by providing the tools and expert advocacy experience needed to ensure a smooth process every year.

2. Get organized. Make sure you are aware of your enrolled patient’s enrollment and expiration dates. This will help you identify which patients will expire first so you can prioritize. This will let you easily check if your patient’s insurance or treatment plan has changed and can make adjustments to their enrollment as needed.

3. Validate program eligibility and forms. It is common for programs to frequently change their eligibility criteria and required forms. A tech platform can automate this process by automatically screening programs online and verifying the correct eligibility and application forms. Without a tech solution, the alternative is more manual and time-consuming, and requires the advocate to call ahead to confirm with the program representative all the documents needed. We recommend doing this as early as September.  

4. Group your re-enrollments by program. When automating this through technology, this is done automatically for you and prioritizes tasks by re-enrollment date. If you have to do this manually, create lists of patients by program to re-enroll for the new year. Then, group them by program so you can be better organized with the phone calls you have to make and document submissions.

5. Monitor for approval. With a tech solution, the submission and subsequent reward is automatically tracked and documented within the platform. There isn’t a need to call the program for this information. However, if you are doing this manually you should call the program and be proactive in understanding these timelines so the approval does not fall through the cracks.

As we approach the end of another re-enrollment season, it's important to reflect on the vital role Patient Advocates play in navigating the complexities of high-cost therapies. The journey isn't easy, and the challenges are many, but the reward of ensuring continuous, affordable care for patients is immeasurable. Remember, preparedness, organization and proactive communication are key to mastering this annual process. By employing these strategies and leveraging technology, we can not only streamline the re-enrollment process but also make a significant difference in the lives of patients.