Please see accompanying Prescribing Information, including Patient Information, for Radicava®, also available at radicava.com.

Understanding Government Health Plan

Options 2018-2019

Understanding Your OptionsVisit medicare.gov for more information or contact a Medicare insurance plan representative with questions about coverage.

You may be eligible for Medicare if you are:

Age 65 or older

• You may enroll in Original Medicare Part A (hospital costs) and Part B (outpatient and doctor fees) health plans

• Prescription drug coverage (Part D) is also available

Under age 65If you have been diagnosed with amyotrophic lateral sclerosis (ALS), you can apply for Social Security Disability Insurance (SSDI) benefits, and subsequently, for Medicare coverage.1,2

Apply as soon as possible to avoid a gap between your commercial insurance and Medicare coverage.

• To apply for SSDI benefits, visit your local Social Security Administration office

• The application process for SSDI benefits can take 3-5 months and payments usually start in your sixth month of disability1,2

Once you apply for SSDI benefits, you may qualify to apply for Medicare almost immediately.2

Visit ssa.gov/medicare or ssa.gov/disabilityssi to learn more about Medicare, SSDI, and to apply online.

Infusion with RADICAVA® (edaravone) IV infusion is typically covered under Medicare Part B.

For home infusion treatment, only the RADICAVA® medication is typically covered under Medicare Part D.3

If you are eligible for Medicare, you are not eligible for any Searchlight Support® cost support programs.

2

We can help you review information about government

health plan options.

Please see accompanying Prescribing Information, including Patient Information, for Radicava®, also available at radicava.com.

See enclosed glossary for helpful health insurance terms.

3

5

Medicare Part D prescription drug plans typically cover the cost of home infusion medications such as RADICAVA®. It is important to note that this coverage applies only to the medication, and not to any related services, equipment, or supplies.3*

Contact your insurance plan representative with questions about your plan’s coverage.

Here’s how it works in 2018:

Supplemental coverage may be available.

• Medicare “Extra Help” Low-Income Subsidy (LIS) may be available to help pay for prescription drug plan costs, including deductibles and out-of-pocket expenses4,7

• A Medicare Advantage plan (Medicare Part C) may include prescription drug coverage and may be available as an alternative to Original Medicare coverage. Some limitations apply4

Medicare Advantage plans vary in coverage benefits and the costs of monthly premiums.

Visit medicare.gov for more information or contact your Medicare insurance plan representative.

Medicare Part D Coverage

You pay 5%

After the “Donut Hole”6 Medicare pays 95%

You pay annual deductible

On average, you pay 25%

Before the “Donut Hole”5

On average, Medicare pays 75%

You pay 35%†In the “Donut Hole”5,6 Part D Program covers 65%†‡

* Coverage may be different for Medicare beneficiaries who are homebound.† Based on Medicare Part D plan information for 2018.‡ Mitsubishi Tanabe Pharma America, Inc., pays 50%; Medicare pays 15%.

4

Supplemental coverage and plans may be available to help with premiums and the 20% of costs for treatment with RADICAVA® (edaravone) IV infusion not covered by Medicare Part B.4

• A Medicare Supplement plan (Medigap) may be able to cover most or even all of your Original Medicare out-of-pocket costs4

• A Medicare Advantage plan (Medicare Part C) may be available as an alternative to Original Medicare coverage. Some limitations apply4

– If enrolled in a Medicare Advantage plan, you cannot enroll in a Medigap plan

Medigap and Medicare Advantage plans vary in coverage benefits and cost of monthly premiums.

Visit medicare.gov or your State Health Insurance Assistance Program (SHIP) at ShipTACenter.org for help with additional Medicare-related questions.

Medicare Part B Coverage

20% After your deductible is met, you typically pay 20% of medication and infusion costs.4

80% Medicare Part B covers 80% of medication and infusion costs.

Please see accompanying Prescribing Information, including Patient Information, for Radicava®, also available at radicava.com.

Call us to learn more or visit us online at radicava.com

radicava.com

7

Call us to learn more or visit us online at radicava.com

radicava.com

6

Other government-funded health plans§

MedicaidBenefits vary by state and some have programs for people with catastrophic or high monthly out-of-pocket healthcare costs.8,9

TRICARE/DoD/Veterans Administration Veterans with ALS who spent at least 90 continuous days in the military may be eligible for 100% disability II

compensation benefits.10,11

This is not a complete list of government health plan options. For other government-funded health plans not listed, please visit HHS.gov.

Alternative resources for cost support and coverageNeed help paying Medicare premium costs?If you have limited income and resources, you may qualify for a Medicare Savings Program. Visit medicare.gov for more information.4

If you need supplemental assistanceIf you have a government health plan, we can refer you to independent foundations that may provide assistance. Contact Searchlight Support® for more information.These foundations are independent, nonprofit organizations that have their own eligibility criteria and application processes. Referral to an independent foundation is not a guarantee of out-of-pocket cost assistance.

Additional Resources

Please see accompanying Prescribing Information, including Patient Information, for Radicava® (edaravone) IV infusion, also available at radicava.com.

§ For questions about your coverage with Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), Puerto Rico Government Health Insurance Plan (“La Reforma”), or other government-funded health plans not listed, speak with a Care Coordinator at Searchlight Support®.

II The Department of Veterans Affairs (VA) assigns benefits based on a percentage of the disability that can be associated with your military service.

Understanding Government Health Plan

Options 2018-2019

References: 1. Disability Benefits. Social Security Administration website. https://www.ssa.gov/pubs/EN-05-10029.pdf. Accessed July 12, 2018. 2. What You Need to Know When You Get Social Security Disability Benefits. Social Security Administration website. https://www.ssa.gov/pubs/EN-05-10153.pdf. Accessed July 12, 2018. 3. Home Infusion Reminder. Centers for Medicare & Medicaid Services website. https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Downloads/HomeInfusionReminder_031006.pdf. Accessed July 12, 2018. 4. Medicare & You 2018. Centers for Medicare & Medicaid Services website. https://www.medicare.gov/pubs/pdf/10050-Medicare-and-You.pdf. Accessed July 12, 2018. 5. Announcement of calendar year (CY) 2018 Medicare Advantage capitation rates and Medicare Advantage and Part D payment policies and final call letter. Centers for Medicare & Medicaid Services website. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2018.pdf. Accessed July 12, 2018. 6. The Medicare Part D Prescription Drug Benefit. Henry J. Kaiser Family Foundation website. https://www.kff.org/medicare/fact-sheet/the-medicare-prescription-drug-benefit-fact-sheet/. Accessed May 4, 2018. 7. If You Get Extra Help, Make Sure You’re Paying the Right Amount. Centers for Medicare & Medicaid Services website. https://www.medicare.gov/Pubs/pdf/11324-If-You-Get-Extra-Help.pdf. Accessed July 12, 2018. 8. Benefits. Medicaid.gov website. https://www.medicaid.gov/medicaid/benefits/index.html. Accessed July 13, 2018. 9. Baicker K, Taubman SL, Allen, HL, et al. The Oregon Experiment—Effects of Medicaid on Clinical Outcomes. N Engl J Med. 2013;368:1713-1722. 10. Department of Veterans Affairs. Presumption of Service Connection for Amyotrophic Lateral Sclerosis. Fed Regist. 2009;74(212):57072-57074. Codified at 38 CFR Part 3. 11. VA Provides Benefits to Veterans with ALS and Families. ALS Association website. http://www.alsa.org/news/archive/va-provides-benefits.html. Accessed July 12, 2018.

Radicava and the Radicava logo are registered trademarks of Mitsubishi Tanabe Pharma Corporation. Searchlight Support is a registered trademark of Mitsubishi Tanabe Pharma America, Inc. For US audiences only. © 2018 Mitsubishi Tanabe Pharma America, Inc. All rights reserved. CP-RC-US-0601 09/18