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Understanding Insurance

Trying to understand healthcare coverage can be confusing. So let us help. Here, we’ll help you understand the differences between commercial or private insurance and government coverage, figure out which one you have, and point you in the right direction to learn more about what this means for you.

Insurance 101

With all of the different health insurance options available, it can be hard to know which is right for you. These videos explain how health insurance works, important things to think about when considering a health plan, and ways to help you make the most of your plan.

What is commercial or private insurance?

Commercial or private insurance is a health insurance plan that is not offered by the government. You can get it through your or your spouse’s job. You can also purchase a commercial plan directly from an insurance carrier, at Healthcare.gov, or an insurance broker.

 
 

Learn more about

Commercial or Private Insurance

What is government coverage?

Government coverage is when your healthcare program is funded by the government. These programs include:
  • Medicare
  • Medicaid
  • Children’s Health Insurance Program (CHIP)
  • The Department of Defense TRICARE (DOD TRICARE)
  • The Veterans Health Administration (VHA) Program
  • The Indian Health Service (IHS) Program
 

Learn more about

Medicare

 

Learn more about

Medicaid

How do I find out what my coverage is?

If you’re not sure what type of healthcare coverage you have, we can help.

Give us a call to speak with a Janssen CarePath Care Coordinator.

What do I do if my healthcare plan does not approve my treatment?

Sometimes, you may not be able to get the medication that your doctor has prescribed for you. For example, your health plan might not cover the medication if it is not on the drug list (formulary). Or your medication cost could be higher than you think it should be. When this happens, you and your doctor can ask your health plan about it. You can also see if your plan can make the medication available to you as an exception.

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IMPORTANT SAFETY INFORMATION
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What is TECVAYLI® (teclistamab-cqyv)?

TECVAYLI® is a prescription medicine to treat adults with multiple myeloma who:

  • have already received at least 4 treatment regimens, including a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 monoclonal antibody to treat their multiple myeloma, and
  • their cancer has come back or did not respond to prior treatment

TECVAYLI® was approved based on patient responses. There are ongoing studies to confirm the clinical benefit of TECVAYLI®.

It is not known if TECVAYLI® is safe and effective in children.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about TECVAYLI®?

TECVAYLI® may cause side effects that are serious, life-threatening, or lead to death, including Cytokine Release Syndrome (CRS) and neurologic problems.

Call your healthcare provider right away if you develop any of the signs or symptoms of CRS or neurologic problems listed below at any time during your treatment with TECVAYLI®:

Cytokine Release Syndrome (CRS). Signs and symptoms of CRS may include:

  • fever (100.4°F or higher)
  • difficulty breathing
  • chills
  • dizziness or lightheadedness
  • fast heartbeat
  • feeling anxious
  • confusion or restlessness
  • headache
  • increased liver enzymes in your blood

Neurologic problems. Symptoms of neurologic problems with TECVAYLI® include:

  • headache
  • jerking movements
  • rigid muscles
  • feeling restless
  • numbness and tingling (feeling like “pins and needles”)
  • confusion
  • trouble speaking
  • muscle spasms
  • tremor
  • double vision
  • changes in your handwriting
  • problems walking
  • muscle weakness in your body or face
  • hearing loss
  • burning, throbbing, or stabbing pain
  • Due to the risk of CRS and neurologic symptoms, you should be hospitalized for 48 hours after all doses of TECVAYLI® that are part of the “step-up dosing schedule.” The “step-up dosing schedule” is when you receive the first 2 doses of TECVAYLI®, which are called “step-up doses,” and then you receive the first “treatment dose” of TECVAYLI®. After “step-up dose 1” of TECVAYLI®, the dose of TECVAYLI® is increased. After “step-up dose 2,” the dose is increased again when you receive the first “treatment dose” of TECVAYLI®.
    • “Step-up dose 1” is given on day 1 of treatment. “Step-up dose 2” is usually given on day 4 of treatment. The first “treatment dose” is usually given on day 7 of treatment.
    • Your healthcare provider will decide when you will receive “step-up dose 2” and your first “treatment dose.”
      • “Step-up dose 2” may be given between 2 to 4 days after “step-up dose 1,” or up to 7 days after “step-up dose 1” if you have certain side effects with TECVAYLI®.
      • Your first “treatment dose” may be given between 2 to 4 days after “step-up dose 2,” or up to 7 days after “step-up dose 2” if you have certain side effects with TECVAYLI®.
    • Your healthcare provider will decide the number of days to wait between your doses of TECVAYLI® as well as how many treatments you will receive.
    • If your dose of TECVAYLI® is delayed for any reason, you may need to repeat the “step-up dosing schedule” to receive TECVAYLI®.
    • Before each “step-up dose” and your first “treatment dose” of TECVAYLI®, you will receive medicines to help reduce your risk of CRS. Your healthcare provider will decide if you need to receive medicines to help reduce your risk of CRS with future doses.
  • Your healthcare provider will monitor you for signs and symptoms of CRS and neurologic problems during treatment with TECVAYLI®, as well as other side effects, and treat you as needed.
  • Do not drive or operate heavy or dangerous machinery during and for 48 hours after your TECVAYLI® “step-up dosing schedule” is completed, or at any time during treatment with TECVAYLI® if you develop new neurologic symptoms until the symptoms go away.

TECVAYLI® is available only through the TECVAYLI® and TALVEY™ Risk Evaluation and Mitigation Strategy (REMS) due to the risk of CRS and neurologic problems.

You will receive a Patient Wallet Card from your healthcare provider. Carry the Patient Wallet Card with you at all times and show it to all of your healthcare providers. The Patient Wallet Card lists signs and symptoms of CRS and neurologic problems.

Get medical help right away if you develop any of the signs and symptoms listed on the Patient Wallet Card. You may need to be treated in a hospital.

  • If you have any questions about TECVAYLI®, ask your healthcare provider.
  • Your healthcare provider may temporarily stop or completely stop your treatment with TECVAYLI® if you develop CRS, neurologic problems, or any other side effects that are severe.

See “What are the possible side effects of TECVAYLI®?” for more information about side effects.

Before you receive TECVAYLI®, tell your healthcare provider about all of your medical conditions, including if you:

  • have an infection
  • are pregnant or plan to become pregnant. TECVAYLI® may harm your unborn baby.
    • Your healthcare provider should do a pregnancy test before you start treatment with TECVAYLI®.
    • You should use effective birth control (contraception) during treatment and for 5 months after your last dose of TECVAYLI®.
    • Tell your healthcare provider right away if you become pregnant or think that you may be pregnant during treatment with TECVAYLI®.
  • are breastfeeding or plan to breastfeed. It is not known if TECVAYLI® passes into your breast milk. Do not breastfeed during treatment and for 5 months after your last dose of TECVAYLI®.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

How will I receive TECVAYLI®?

  • TECVAYLI® will be given to you by your healthcare provider as an injection under your skin (subcutaneous injection), usually in your stomach area (abdomen). Your thigh or another area of your body may be injected.
  • See “What is the most important information I should know about TECVAYLI®?” at the beginning of this Important Safety Information for information about how you will receive TECVAYLI®.

If you miss any appointments, call your healthcare provider as soon as possible to reschedule your appointment. It is important for you to be monitored closely for side effects during treatment with TECVAYLI®.

What are the possible side effects of TECVAYLI®?

TECVAYLI® may cause serious side effects, including:

  • See “What is the most important information I should know about TECVAYLI®?”
  • Liver problems. TECVAYLI® can cause liver problems that may lead to death. Increased bilirubin and liver enzymes in your blood are common with TECVAYLI® and can also sometimes be severe. These increases in liver enzymes can happen with or without you also having CRS. Your healthcare provider will monitor you for these problems before you start and during treatment with TECVAYLI®. Tell your healthcare provider if you develop any symptoms of a liver problem including:
  • tiredness
  • loss of appetite
  • pain in your right upper stomach area (abdomen)
  • dark urine
  • yellowing of your skin or white part of your eyes
  • Infections. Upper respiratory tract infections and pneumonia are common with TECVAYLI®. TECVAYLI® can cause bacterial and viral infections that are severe, life-threatening, or that may lead to death.
    • Your healthcare provider will monitor you for signs and symptoms of infection before and during treatment with TECVAYLI®.
    • Your healthcare provider may prescribe medicines for you to help prevent infections, and treat you as needed if you develop an infection during treatment with TECVAYLI®.
    • Tell your healthcare provider right away if you get a fever, chills, or any signs or symptoms of an infection.
  • Decreased white blood cell counts. Decreased white blood cell counts are common with TECVAYLI® and can also be severe. Fever sometimes also happens with low white blood cell counts and may be a sign that you have an infection. Your healthcare provider will check your blood cell counts before you start and during treatment with TECVAYLI®, and treat you as needed.
  • Allergic reactions and injection site reactions. TECVAYLI® can cause allergic reactions that can affect your whole body (systemic), and also cause injection site reactions.
    • Some people taking TECVAYLI® can develop symptoms of an allergic reaction that can affect their whole body and may include fever or a swollen tongue. Get medical help right away if you develop symptoms of an allergic reaction during treatment with TECVAYLI®.
    • Injection site reactions are common with TECVAYLI® and can include: redness, heat, swelling, bruising, bacterial skin infection (cellulitis), discomfort, blood collection under the skin at the injection site (hematoma), and rash. Tell your healthcare provider if you develop any severe injection site reactions.

Your healthcare provider may temporarily or permanently stop TECVAYLI® if you have any of the side effects listed above and they are severe.

The most common side effects of TECVAYLI® include:

  • fever
  • pain in your joints and muscles, back and chest muscles, and in your arms and legs
  • tiredness and weakness
  • upper respiratory tract infections and pneumonia. See “Infections” above.
  • nausea
  • headache
  • diarrhea

The most common severe abnormal lab test results with TECVAYLI® include: decreased white blood cells, red blood cells, and platelets.

These are not all the possible side effects of TECVAYLI®.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Please read full Prescribing Information, including Boxed WARNING, for TECVAYLI®.

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