Copayments will be waived retroactively to March 18 for certain testing and office visits related to the testing. The test must be one approved, cleared, or authorized by the Food and Drug Administration to detect SARS-CoV-2 or diagnose COVID-19. Save on your prescription and receive NAYZILAM support. Eligible commercial patients. may pay as little as $20 per box of NAYZILAM ® (midazolam) nasal spray, CIV. Just present the NAYZILAM Patient Savings Card at your pharmacy when filling your prescription. The program offers many sophisticated online tools to ensure the application process is as streamlined as possible for patients, providers, and pharmacy representatives, including 24-hour web-based portals, electronic signature, document upload, and bar code fax routing capabilities.
Save on your prescription and receive NAYZILAM support
Eligible commercial patients* may pay as little as $20 per box of NAYZILAM® (midazolam) nasal spray, CIV. Just present the NAYZILAM Patient Savings Card at your pharmacy when filling your prescription. Patients who are covered by any state or federal program are not eligible. Please see Eligibility Criteria and Terms.
The NAYZILAM Patient Savings Card will expire at the end of the calendar year.
Here’s how to start saving with the NAYZILAM Patient Savings Card:
2Register for your card
3Present the card at the pharmacy when filling your prescription
HAVING TROUBLE GETTING STARTED?
If you have questions on your eligibility or how to sign up for the NAYZILAM Patient Savings Card, you can also call OPUS Health at 1-888-786-5879.
Patient Assistance Program
UCB, the maker of NAYZILAM, remains committed to helping epilepsy patients gain access to the medicines we manufacture. The NAYZILAM Patient Assistance Program may be able to help if you do not have health insurance or if you otherwise cannot afford your NAYZILAM medicine.
The NAYZILAM Patient Assistance Program may provide medication at no cost to eligible patients who are unable to pay for their NAYZILAM prescription.
To find out if you might be eligible for assistance, or to learn more about the NAYZILAM Patient Assistance Program, contact ucbCARES®.
Get started by reviewing the program instructions and filling out the application form.
Copay Auctions
ucbCARES is the hub for information on all UCB products. Reach out to our team of nurses, pharmacists, and customer service professionals to:
- Ask questions about UCB products
- Report side effects or product quality concerns
- Get clinical trial information and support
- Find information on affording your UCB medication
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Eligibility Criteria and Terms: This savings card is not valid for use by patients who are covered by any federally funded or state-funded healthcare program (including, but not limited to, Medicare [Part D and Medigap] and those who are Medicare-eligible and enrolled in an employer-sponsored health plan for retirees, Medicaid, any state pharmaceutical assistance program, TRICARE, VA, or DoD), or for cash-paying patients. Offer good only in the U.S., including Puerto Rico. This card is good for use only with a valid NAYZILAM prescription consistent with the approved FDA labeling at the time the prescription is filled by the pharmacist and dispensed to the patient. The maximum annual benefit amount is $1200 per calendar year. Void where prohibited by law, taxed, or restricted. This offer cannot be combined with any other promotional offer. UCB, Inc. reserves the right to rescind, revoke, or amend this offer without notice at any time. No cash value. Not eligible for sale, purchase, trade, or counterfeit.
TO PATIENT: When you use this card, you are certifying that you meet the complete Eligibility Criteria and Terms and that you have not submitted, and will not submit, a claim for reimbursement under any federal, state or other governmental programs for this prescription. If you have any questions regarding the NAYZILAM Patient Savings Program or wish to discontinue your participation, please call 1-888-786-5879 (8:30 am – 5:30 pm ET, Monday – Friday and 8:30 am – 2 pm ET, Saturday).
TO PHARMACIST: Your acceptance of this card and your submission of claims for the NAYZILAM Patient Savings Program are subject to the Terms and Conditions established by OPUS Health. Submit the claim to the Primary Third-Party Payer first, then submit the balance due to OPUS Health as a Secondary Payer as a co-pay only billing using Other Coverage Code indication. You will receive the remaining balance, plus a handling fee, in your next reimbursement from OPUS Health. If you have questions, please contact the OPUS Pharmacy Support line at 1-888-786-5879.
A copay is your share of a medical bill after the insurance provider has contributed its financial portion. Medicare copays (also called copayments) most often come in the form of a flat-fee and typically kick in after a deductible is met.
A deductible is the amount you must pay out of pocket before the benefits of the health insurance policy begin to pay.
Understanding Medicare Copayments & Coinsurance
Medicare copayments and coinsurance can be broken down by each part of Original Medicare (Part A and Part B). All costs and figures listed below are for 2021.
Medicare Part A
After meeting a deductible of $1,484, Medicare Part A beneficiaries can expect to pay coinsurance for each day of an inpatient stay in a hospital, mental health facility or skilled nursing facility. Even though it's called coinsurance, it operates like a copay.
- For hospital and mental health facility stays, the first 60 days require no Medicare coinsurance
- Days 61 to 90 require a coinsurance of $371 per day
- Days 91 and beyond come with a $742 per day coinsurance for a total of 60 “lifetime reserve' days
These lifetime reserve days do not reset after the benefit period ends. Once the 60 lifetime reserve days are exhausted, the patient is then responsible for all costs.
For a stay at a skilled nursing facility, the first 20 days do not require a Medicare copay. From day 21 to day 100, a coinsurance of $185.50 is required for each day. Beyond 100 days, the patient is then responsible for all costs.
Under hospice care, you may be required to make copayments of no more than $5 for drugs and other products related to pain relief and symptom control, as well as a 5% coinsurance payment for respite care.
Under Part A of Medicare, a 20% coinsurance may also apply to durable medical equipment utilized for home health care.
Medicare Part B
Once the Medicare Part B deductible is met, you may be responsible for 20% of the Medicare-approved amount for most covered services. The Medicare-approved amount is the maximum amount that a doctor or other health care provider can be paid by Medicare.
Copay For Surgery
Some screenings and other preventive services covered by Part B do not require any Medicare copays or coinsurance.
Understanding Medicare Deductibles
Medicare Part A and Medicare Part B each have their own deductibles and their own rules for how they function.
Medicare Part A
The Medicare Part A deductible in 2021 is $1,484 per benefit period. You must meet this deductible before Medicare pays for any Part A services in each benefit period.
Medicare Part A benefit periods are based on how long you've been discharged from the hospital. A benefit period begins the day you are admitted to a hospital or skilled nursing facility for an inpatient stay, and it ends once you have been out of the facility for 60 consecutive days. If you were to be readmitted after 60 days of being home, a new benefit period would start, and you would be responsible for meeting the entire deductible again.
Medicare Part B
The Medicare Part B deductible in 2021 is $203 per year. You must meet this deductible before Medicare pays for any Part B services.
Unlike the Part A deductible, Part B only requires you to pay one deductible per year, no matter how often you see the doctor. After your Part B deductible is met, you typically pay 20 percent of the Medicare-approved amount for most doctor services. This 20 percent is known as your Medicare Part B coinsurance (mentioned in the section above).
Cover your Medicare out-of-pocket costs
There is one way that many Medicare enrollees get help covering their Medicare out-of-pocket costs.
Medigap insurance plans are a form of private health insurance that help supplement your Original Medicare coverage. You pay a premium to a private insurance company for enrollment in a Medigap plan, and the Medigap insurance helps pay for certain Medicare out-of-pocket costs including certain deductibles, copayments and coinsurance.
The chart below shows which Medigap plans cover certain Medicare costs including the ones previously discussed.
Click here to view enlarged chartScroll to the right to continue reading the chart
Medicare Supplement Benefits
Part A coinsurance and hospital coverage
Part B coinsurance or copayment
Part A hospice care coinsurance or copayment
First 3 pints of blood
Skilled nursing facility coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign travel emergency
| A | B | C* | D | F1* | G1 | K2 | L3 | M | N4 |
|---|---|---|---|---|---|---|---|---|---|
| 50% | 75% | ||||||||
| 50% | 75% | ||||||||
| 50% | 75% | ||||||||
| 50% | 75% | ||||||||
| 50% | 75% | 50% | |||||||
| 80% | 80% | 80% | 80% | 80% | 80% |
* Plan F and Plan C are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. If you became eligible for Medicare before 2020, you may still be able to enroll in Plan F or Plan C as long as they are available in your area.
+ Read more1 Plans F and G offer high-deductible plans that each have an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high-deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2 Plan K has an out-of-pocket yearly limit of $6,220 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3 Plan L has an out-of-pocket yearly limit of $3,110 in 2021. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.
- Read lessIf you're ready to get help paying for Medicare out-of-pocket costs, you can apply for a Medigap policy today.
Find Medigap plans in your area.
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