The Patient S Medication Or Product Must Be Listed on PAN S List of Covered Medications
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The Patient Access Network (PAN) Foundation is an independent national 501 (c) (3) organization that provides assistance to underinsured patients for their out-of-pocket expenses through more than 50 disease-specific funds including. PAN has an administrative fee of only 5%. This means that $0.95 of every dollar donated to PAN goes directly to patients.
Eligibility
Patient must be have health insurance that covers the medication for which patient seeks assistance. The patient’s medication or product must be listed on PAN’s list of covered medications. Patient must reside and receive treatment in the US. Patient’s income must be at or below 400% or 500% of the Federal Poverty Level, depending on fund-specific requirements
Diseases Targeted
Medications Covered
Contact Information for Applications www.panfoundation.org PAN Foundation P.O. Box 221858 Charlotte, NC 28222-1858 1-866-316-PANF (7263) E-mail: [email protected] Patient Services, Inc. (PSI) is a non-profit charitable organization which provides a "safety net" for patients with chronic illnesses struggling to keep up with expensive premiums and co-payments.:
Eligibility
Families affected by the listed Illnesses and Conditions are eligible to apply. Assistance is determined using a sliding scale that includes several factors such as household income, number of dependents and the state in which a person lives. Patient must have insurance, reside in the US and receive treatment from a US provider.
Diseases Targeted
Medications Covered
Contact Information www.patientservicesinc.org Patient Services, Inc. P.O. Box 5930 Midlothian, VA 23112 1-800-366-7741 Good Days helps qualifying patients pay their insurance copays so they can get immediate access to prescription medications that will give them relief from pain and suffering for more than 30 disease states.
Eligibility
Patients must have valid medical insurance coverage. Please note, patients who are applying for co-payment assistance must have at least 50% insurance coverage or more to be eligible for copayment assistance, excluding deductibles. Patients must have been prescribed a medication that is part of the Good Days formulary Patients must meet annual household income criteria
Diseases Targeted & Medications Covered
Contact Information http://www.mygooddays.org/ Good Days 6900 Dallas Parkway, Suite 20 Plano, TX 75024 1-877-968-7233 Email: [email protected] HealthWell Foundation provides financial assistance to eligible individuals to cover coinsurance, copayments, health care premiums and deductibles for certain medications and therapies. If an insured patient has been prescribed a medication and cannot afford the coinsurance or copayment required, the HealthWell Foundation may be able to help by paying for part of the costs associated with the medication. Also, if a patient is eligible for health insurance, but cannot afford the insurance premium, HealthWell may be able to help with the costs of the insurance premium.
Eligibility Based on an individual’s medical, financial and insurance situation. Must be treated for disease currently covered Must have insurance that covers medication Income must fall within guidelines 400-500% FPL. Number in household and cost of living in a particular city or state is also considered. Diseases Targeted & Medications Covered
Contact Information www.healthwellfoundation.org The HealthWell Foundation P.O. Box 220410 Chantilly, VA 20153-0410 1-800-675-8416 Email: [email protected] Caring Voice Coalition, founded in 2003, was formalized to help patients with rare, chronic or life-threatening illnesses (orphan diseases).
Eligibility Patient must have one of the specific chronic illnesses supported by Caring Voice Coalition Demonstrate financial hardship Have a prescription co-payment or health insurance premiums that he or she cannot afford to pay Be on an expensive FDA-approved therapy for the treatment of his/her disease which is covered under the patients health insurance policy Reside in the US or one of its territories Not be receiving or eligible for assistance from other charitable organizations
Diseases Targeted
Contact Information www.caringvoice.org Caring Voice Coalition, Inc. 8249 Meadowbridge Road Mechanicsville, VA 23116 1-888-267-1440 Toll-Free The Assistance Fund offers financial assistance programs
Eligibility US Citizen or permanent resident Meet financial criteria based on household size and household income Diagnosed with a program related illness Prescribed one of the supported medications for treatment of the disease Insurance coverage for the prescribed medication
Diseases Targeted
Contact Information www.theassistancefund.org The Assistance Fund, Inc. 4700 Millenia Boulevard, Suite 500 Orlando, FL 32839 1-855-845-3663 The Patient Advocate Foundation (PAF) Co-Pay Relief Program (CPR) provides direct financial support for pharmaceutical co-payments, co-insurance and deductibles required to insured patients.
Eligibility
Patient must have active insurance coverage for the medication(s) they are requesting financial assistance Patient must have a physician confirmed diagnosis Patient income must fall at or below income guidelines of the fund which they are requesting financial assistance. 300% or 400% or less of the federal poverty level for where you live
Diseases Targeted
Contact Information www.copays.org Co-Pay Relief 421 Butler Farm Road Hampton, VA 23666 1-866-532-5274 Toll-Free The CancerCare Co-Payment Assistance Foundation is a nonprofit organization that helps people being treated for cancer afford co-payments for chemotherapy and targeted treatment drugs, ensuring their access to care for prescribed treatments. The Foundation is affiliated with CancerCare, a national nonprofit organization founded in 1944 that provides free, professional support services to individuals, families, caregivers, and the bereaved to help them better cope with and manage the emotional and practical challenges arising from cancer. Services include counseling and support groups, educational publications and workshops, and financial assistance. All services are provided by professional oncology social workers and are offered completely free of charge.
Eligibility
Patients with household incomes up to four times (400%) the federal poverty level may qualify. Patient must be diagnosed with one of the cancer types that the Foundation currently covers. If patient diagnosis is not listed, co-payment specialists can provide information about other possible assistance programs. Diagnosis must be verified by a doctor who must complete and sign the physician verification form. Patient must be in active chemotherapy or targeted treatment when application is submitted to the Foundation and at the time of approval. Patient must receive treatment in the US.
Diseases Targeted
Medications Covered
Contact Information www.CancerCare.org www.CancerCareCopay.org CancerCare Co-Payment Assistance Foundation 275 Seventh Avenue, 22nd Floor New York, NY 10001 1-866-55-COPAY (866-552-6729) The Leukemia & Lymphoma Society (LLS) has been dedicated to curing leukemia, lymphoma and myeloma since 1949. LLS is the world's largest voluntary (nonprofit) health organization dedicated to funding blood cancer research and providing education and patient services. The Leukemia & Lymphoma Society Co-Pay Assistance Program helps you pay your insurance premiums and meet co-pay obligations. It also helps find additional sources of financial help. LLS's Co-Pay Assistance Program offers financial help toward:
cancer treatment-related co-pays private health insurance premiums private insurance co-pay obligations Medicare Part B, Medicare Plan D, Medicare Supplementary Health Insurance, Medicare Advantage premium, Medicaid Spend-down or co-pay obligations
Eligibility Patient must have prescription insurance coverage to qualify and maintain insurance coverage at all times and the requested assistance must be covered by the patient’s insurance carrier. Provider must confirm patient diagnosis is currently covered in the LLS’s Co-Pay Assistance Program. Patient must have household income at or within 500% of the federal poverty guidelines. Patient must reside in the US or Puerto Rico and be medically and financially qualified.
Diseases Targeted
Contact Information www.lls.org https://www.lls.org/support/financial-support/co-pay-assistance-program The Luekemia & Lymphoma Society Co-Pay Assistance Program P.O. Box 12268 Newport News, VA 23612 1-877-557-2672 Toll-Free Email: [email protected] The American Kidney Fund (AKF) was founded in 1971 and leads the nation in providing charitable assistance to dialysis patients who need help with the costs associated with treating kidney failure. In 2011, nearly 90,000 people—almost 1 out of every 4 dialysis patients in the United States—received assistance from the American Kidney Fund for health insurance premiums and other treatment-related expenses.
Through the Health Insurance Premium Program (HIPP), the American Kidney Fund pays Part B Medicare, Medigap, commercial, and COBRA premiums for dialysis patients who have insufficient income and savings. These premium payments allow patients to continue their health insurance coverage, enabling access to physician care and medical treatment.
Eligibility
Applicants must be dialyzed in the U.S. or its territories and referred to AKF by their renal social worker and/or nephrologist. Applicants must demonstrate that they can’t afford health coverage and meet the program's financial eligibility criteria. Primary and secondary assistance is available only. HIPP does not assist with tertiary coverage of any kind. Transplant patients are not eligible for HIPP. HIPP enrollees will no longer be eligible for premium assistance after they receive a kidney transplant.
Disease Targeted – Kidney Disease
Financial Assistance
Contact Information www.kidneyfund.org American Kidney Fund 11921 Rockville Pike, Suite 300 Rockville, MD 20852 1-800-638-8299