Gene therapy is a technique that changes a person’s genes to treat or cure a disease. Gene therapies can work by1:
Replacing a disease-causing gene with a healthy copy of the gene.
Inactivating a disease-causing gene that is not functioning properly.
Introducing a new or modified gene into the body to help treat the disease.
With Gene Therapy Protection, self-funded clients can reduce the financial risk surrounding these life-saving therapies and ensure patients get the best possible treatments.
A member is diagnosed with Hemophilia B.
The member needs gene therapy to cure their life-threatening condition and the treatment is covered by their employer’s plan.
The member’s employer added Gene Therapy Protection to their stop loss policy, so the plan doesn’t have to worry about the high cost of the treatment.
The member receives the treatment, and the plan’s cost is completely covered by the stop loss policy, other than the plan sponsor’s obligation to cover the state minimum specific deductible.2
2 - Please refer to the Excess Loss Insurance Policy for actual coverage terms and limitations.