NORD: Chronic Granulomatous Disease (CGD) (Copay): Waitlist

Funded

About

The NORD: Chronic Granulomatous Disease (CGD) Copay Program provides valuable financial assistance for patients diagnosed with CGD, specifically for insurance copays related to essential drugs like Rayos, Actimmune, Cyclophosphamide, and Posaconazole. Designed to alleviate the financial burden on patients, the NORD CGD Copay Program ensures that participants who meet specific eligibility criteria can receive the support they need effectively.

Insurance requirements: Commercially insured, Medicare / Medicaid

Enrollment Forms

Enrollment Form

Program Requirements

•Valid only for residents in the US and Puerto Rico

•Enrollment Required: Yes

•Coverage Required: No

•Needs Based: Yes

•Activation Required: No

Program Details

•Please note the following:

•1. Program offers assistance with insurance copays only; this program does not assist with copayments for medications

•2. Specific drug coverage is not indicated on program website; drug coverage must be verified by calling program

•3. Specialty Pharmacy representatives/case managers can send new referrals through the referral portal (https://rareaccess.org/#/login). Representatives must be preregistered by sending a request to RareAccess@rarediseases.org. Representatives can also email the program email address. To make the problem resolution quicker and more efficient please do not send messages to individual emails. If the matter is URGENT, please reach out to SP account manager for NORD to escalate the issue

•Patients may apply online, call (8552015096) or email (CGDassist@rarediseases.org) program to enroll

•Awards are made for a calendar year, and patients may reapply for subsequent years

•NORD is able to offer same day approval for programs

•Patients must undergo a financial evaluation of need, and provide HIPPA authorization and accept a waiver of liability

•Fax number for program is 2034868462

Enrollment Forms

Enrollment Form