Insurance & Disability Resource Hub
Finding support shouldn’t be this hard.
A note on outside resources: Where we link to external organizations, businesses, or websites, we’re simply sharing information that may be helpful to the HS community. These links do not represent an endorsement, affiliation, or paid partnership of any kind. Always use your own judgment when engaging with any third-party organization.
What are you trying to figure out right now?
Insurance and disability paperwork rarely follow a straight line. Choose the situation that best matches what’s happening now, and we’ll walk you through the next step without making you dig through the entire resource hub.
“Challenges along the way don’t mean there’s no option left — and you don’t have to figure this out by yourself.” — a reminder from the HS Connect community
This tool shares general, educational information based on common patterns in the HS community — it isn’t medical, legal, or insurance advice, and it doesn’t speak for any specific plan, employer, or program. Coverage rules vary by state and by policy, so always confirm details with your insurer, provider, or a qualified professional. Every person’s situation is different.
You’ve been prescribed a biologic.
Here’s what typically happens next. Every insurance plan and medication is different, but this interactive guide walks through the common steps from prescription to your first fill.
Your provider sends the prescription
Your healthcare provider sends your biologic prescription to the specialty pharmacy or access team that will begin coordinating the next steps.
What you can do
Things to keep in mind
Major Specialty Pharmacies
Many biologics and specialty medications must be filled through a specialty pharmacy selected by your insurance plan. If you are not sure which pharmacy you should use, check your insurance card, member portal, or call the pharmacy-benefit number on your card before transferring a prescription.
CVS Specialty
1-800-237-2767Patient support for specialty prescriptions, refills, medication questions, insurance, billing, and financial-assistance questions.
Accredo
1-800-803-2523Patient services for specialty prescriptions, refills, orders, delivery, and general pharmacy support.
Optum Specialty Pharmacy
1-855-427-4682Patient support for specialty prescriptions and complex therapies, including medication-access and order questions.
Walgreens Specialty Pharmacy
1-888-782-8443Specialty pharmacy support for prescription coordination, delivery, insurance verification, and medication access.
CenterWell Specialty Pharmacy
1-800-486-2668Specialty and complex medication support. Network participation and pharmacy requirements depend on the individual insurance plan.
Looking for a specialty pharmacy near you?
Some independent and health-system specialty pharmacies serve local communities. Your insurance network may limit which pharmacy can fill the prescription, so confirm coverage before transferring it.
Best place to start: Call the pharmacy-benefit number on your insurance card or use your insurer’s online pharmacy directory and ask which specialty pharmacies are in-network for your medication.
Insurance Coverage & Financial Assistance
Navigating insurance for HS treatments can be exhausting. The programs below are offered directly by pharmaceutical manufacturers to help reduce out-of-pocket costs. Please note these are generally not available to those enrolled in government-sponsored insurance, including Medicaid and Medicare.
UCB Financial Assistance — for Bimzelx
UCB offers patient assistance programs designed to help reduce costs for eligible patients prescribed Bimzelx.
Visit UCB Financial Assistance ↗Novartis Patient Assistance Program — for Cosentyx
Novartis offers financial support options for eligible patients who have been prescribed Cosentyx.
Visit Novartis Patient Assistance ↗Dollar For — Medical Bill Charity Care
Dollar For is a nonprofit that helps patients find and apply for hospital charity care programs, which can significantly reduce or eliminate medical bills. Their assistance is free.
Visit Dollar For ↗HS Connect State Insurance Coverage Guide
A state-by-state overview of insurance coverage information relevant to HS patients, compiled by HS Connect.
Download the guide PDF ↗Prior Authorization Templates
If your provider is having difficulty getting a treatment approved by insurance, prior authorization templates can help. These were created by the HS Foundation and are free to use. You can share the link directly with your provider or print out the template for the specific medication.
Full Prior Authorization Template Library
The HS Foundation maintains a complete library of PA templates organized by medication. Visit their site to find and download the template for the treatment your doctor is seeking approval for.
View all PA Templates on the HS Foundation site ↗Disability Support Resources
HS can significantly impact your ability to work. If you’re exploring disability benefits, the resources below can help you understand your options. These are external resources shared for informational purposes — HS Connect is not affiliated with these organizations.
Liner Legal — Disability Forms & Guides
Liner Legal is a disability law firm that has published a library of public guides and forms for people navigating Social Security Disability, SSI, and Long-Term Disability claims. We’re sharing their public resource library because it contains useful information for the HS community. This is not an endorsement or referral to the firm.
- Full Forms & Guides Library — complete overview of all available resources
- Understanding the Disability Application Process
- SSA-3369: Work History Report — documents your employment history for SSA evaluation
- SSA-3373: Function Report Adult — explains how your condition affects daily life
- SSA-3380: Third Party Function Report — completed by a caregiver, family member, or friend
- SSA-3441: Disability Report Appeal — for use if your application was denied and you’re requesting reconsideration
- HS Connect Disability Terms Glossary — plain-language definitions on this page
- SSDI/SSI Frequently Asked Questions
HS Connect Disability Terms Glossary
Common Social Security disability terms in plain language. These definitions are educational summaries; Social Security’s rules and annual dollar amounts can change.
SSDI
Social Security Disability Insurance. A federal disability benefit tied to your work history and Social Security work credits.
SSI
Supplemental Security Income. A needs-based federal program for eligible people with limited income and resources who are disabled, blind, or age 65 or older.
Disability
For an adult Social Security disability claim, SSA generally looks for a medically determinable condition that prevents substantial gainful activity and has lasted, or is expected to last, at least 12 continuous months or result in death.
SGA
Substantial Gainful Activity. A level of work activity and earnings SSA uses when evaluating disability. The earnings amounts are adjusted over time, so check SSA for the current year’s figure.
Work credits
Credits earned through wages or self-employment covered by Social Security. SSDI eligibility generally requires enough credits, including enough recent work; the number needed depends in part on your age when disability begins.
DDS
Disability Determination Services. The state agency that develops medical evidence and makes the initial medical disability determination for Social Security.
Reconsideration
The first level of administrative appeal after many initial Social Security disability denials. A different reviewer considers the claim and any additional evidence.
ALJ hearing
Administrative Law Judge hearing. A later appeal level where an administrative law judge reviews the case after reconsideration.
Appeals Council
A Social Security appeal level that can review an ALJ decision. Federal court review may follow after the administrative appeal process.
Continuing Disability Review (CDR)
A periodic review Social Security may conduct to determine whether a beneficiary continues to meet the program’s disability requirements.
Disability & Legal Resources by State
The following resources were compiled by the HS Foundation. As they note: “The HS Foundation is not affiliated with any of these states or resources, nor do we provide any endorsement.” We’re sharing this as a convenient reference for the HS community.