Whether you have commercial (private) or another type of insurance, this information can help you understand the steps you, your healthcare provider, and your pharmacy will take to get your Pfizer migraine medication as prescribed.

Next Steps for Getting Your Pfizer Migraine Medication

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Cost and Coverage Questions to Ask

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STEP 1
Checking insurance coverage
After receiving your prescription, the pharmacy will verify your insurance coverage for the medication and inform both you and your healthcare provider about the status of the prescription.

Make sure your healthcare provider has the most current information about your prescription drug insurance

If you have commercial (private) insurance, you may be eligible to sign up for a Pfizer migraine medication copay savings program. Click here to learn more

STEP 2
Requesting insurance approval
Your healthcare provider’s office will likely need to send additional information to your insurance plan, known as requesting a prior authorization (PA), before the insurance plan will begin paying for your medication.

To help with the PA, confirm that your healthcare provider has the following information:

  • Migraine medications you’re currently taking or have taken in the past
  • Reasons for stopping any migraine medications, such as side effects
STEP 3
Following up on your prescription status
  • Depending on your insurance plan, it may take them a few days to up to 30 days to make a decision on the PA
    • You may have to pay the full cash price for your medication if you choose to pick it up before a decision is made on the PA
You can contact your healthcare provider or your insurance plan to confirm the status of the PA

Addressing insurance denials

  • If the insurance plan does not approve the PA, your healthcare provider’s office may send more specific information and documents to the plan to ask them to overturn their decision
    • This step is referred to as submitting an appeal

You can ask the insurance plan to reconsider its decision, or you can ask your healthcare provider to start this process

  • You can find out why coverage was denied by contacting your insurance plan

If your healthcare provider’s office reaches out to ask you for additional information, be sure to provide it in a timely manner

STEP 4
Paying for and receiving your medication
  • If you have commercial (private) insurance and have activated your savings card:
    • Once the PA is approved, you may continue to use a Pfizer migraine medication savings card at the pharmacy. Click here to learn more
  • If you have another type of insurance or questions about accessing your Pfizer migraine medication:
    • Reach out to a Pfizer Migraine Patient Access Coordinator for more information by calling 1-866-222-4183, Monday-Friday, 8 AM-8 PM ET

If you have commercial (private) insurance, make sure that you have activated your savings card

You can pick up your prescription from your local pharmacy. You may also contact your insurance to see if home delivery is an option (additional costs may apply)

You also have the option to pay the full cash price for your medication if your PA is not approved

Know who covers your prescription medications

Be sure that your healthcare provider's office has your most current prescription insurance information. You can find this information on your insurance card. If your insurance card lists an “Rx BIN” and “Rx PCN,” be sure to provide these numbers. You can also find your insurance plan’s phone number on the back of the card.

If you have a different insurance than the types shown here or questions about accessing your Pfizer migraine medication, you can reach out to a Pfizer Migraine Patient Access Coordinator for assistance.

Commercial (Private) Insurance*

Primary Insurance plan

Example of Commercial Insurance Card

  • Your insurance card will include a section for "Rx BIN," "Rx PCN," and "Rx Grp," if your primary plan covers prescription medications

Pharmacy Benefit Manager (PBM)

Example of Pharmacy Benefit Manager (PBM) Insurance Card

  • A pharmacy benefit manager, or PBM, is a company that handles prescription medication coverage for insurance plans, medical providers, or employers
  • If a PBM manages prescription medication for your insurance plan, you may have a separate insurance card
*Card images and insurance information are shown for example only.
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