Evernorth Embarc Benefit Protection®
Embarc Benefit Protection
This novel solution addresses the critical need facing everyone from payers to patients by delivering better care, affordability and access. As the industry’s first solution to build a new pathway to pay for the coming wave of expensive, potentially curative therapies, Embarc Benefit Protection® will change the future of health care.
The solution includes:
- Luxturna® (voretigene neparvovec-rzyl): The first FDA-approved prescription gene therapy for people with inherited retinal disease
- Zolgensma® (onasemnogene abeparvovec-xioi)3: A gene therapy for children under 2 years old with spinal muscular atrophy
- ZYNTEGLO® (betibeglogene automemcel)4: Used for a blood disorder known as beta thalassemia in patients 12 years and older who cannot make enough beta-globin and require regular blood transfusions
- Additional therapies may be added in the future
Together, the path is clear
Like our Patient Assurance Program® and Digital Health Formulary, Embarc Benefit Protection demonstrates what our combined company can do for our clients and patients to deliver on the promise of modern medicine. Our goal is to help make these life-changing, high-cost gene therapies accessible to the people who need them – as soon as possible.
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3 The financial protection against the high cost of Zolgensma applies only to children born after the Embarc Benefit Protection solution is effective for their group.
4 For existing Embarc Benefit Protection clients with effective dates of 08/01/2022 or earlier, all members who meet the solution’s clinical and network criteria for ZYNTEGLO will be able to access the drug through Embarc Benefit Protection. For clients who join Embarc Benefit Protection after 08/01/2022, the financial protection extends only to members who join the underlying medical coverage 30 days after the client is effective in Embarc Benefit Protection.
* If a member is enrolled in a high deductible health plan and has not met their deductible for that plan year, there may be out-of-pocket costs associated