Expenses covered by TotalAssist
Ways to pay for covered expenses
- Use your TotalAssist Pharmacy Card at pharmacies or specialty pharmacies to pay for your copays. It works just like using cash at the pharmacy!
- Your pharmacy or healthcare provider can submit a claim directly to us.
- Submit a claim to pay a bill from a pharmacy, provider, or health insurance company which you have not yet paid.
- TotalAssist can pay you back (reimburse you) for covered expenses you pay for out-of-pocket.
- TotalAssist can also reimburse you for expenses you paid out-of-pocket within the “look back period” of 6 months prior to your award date.
What is a claim?
This is the word for submitting expenses to be paid from your TotalAssist grant.
Covered expenses
You can use your TotalAssist grant to help pay for your out-of-pocket healthcare costs for:
- Medication copays, coinsurance, and deductibles
- Health insurance premiums
- Office visit charges the day of treatment
- Administration charges related to treatment
TotalAssist grants cannot be used to pay for:
- Dental, vision, or life insurance premiums
- Prescriptions when a discount prescription card is used
- Medical services such as lab work, radiation therapy, scans, and surgery
Learn more about claims and expenses for:
Other covered expenses and claims guides:
Testing and assessment grants
Transportation grants
What does this expense mean?
Covered expenses are the out-of-pocket healthcare costs you can use your grant to pay for. Below are definitions for those expense terms.
Administration charges related to treatment
Some examples of administration charges or fees include no-show fees, fees for requesting a copy of your medical records, or prescription refill fees (not copays).
Coinsurance
In health insurance, coinsurance refers to the percent of medical costs the patient pays out-of-pocket after meeting their deductible. Coinsurance varies by insurance plan.
Copays
In health insurance, copays are an amount the patient pays out-of-pocket for a covered health care service or prescription, each time you receive the service or prescription.
Deductibles
In health insurance, the deductible is the amount the patient pays toward covered out-of-pocket costs before your insurance pays for the rest—either partially (coinsurance) or fully, depending on your plan. Plans vary, but may have deductibles for prescriptions, in-network services, out-of-network services, and/or a yearly deductible.
Office visit charges the day of treatment
One example of office visit charges the day of treatment is a “facility fee.”
Premiums
A health insurance premium is the fixed amount you pay, usually monthly or quarterly, to keep your coverage active, whether or not you use medical services.
Need more help?
Chat live or call 866-512-3861, Mon - Fri, 8:30am - 5:30pm ET.
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