NORD: Lennox-Gastaut Syndrome (LGS) (Premium & Copay)

Funded

About

The NORD: Lennox-Gastaut Syndrome (LGS) (Premium & Copay) program offers invaluable support to patients diagnosed with Lennox-Gastaut Syndrome who require assistance with insurance premiums and copays for the drugs Onfi, Banzel, Epidiolex, Fintepla, and Felbatol. This program ensures that eligible individuals, who meet the financial and residency criteria, can access the necessary treatments without the burden of excessive costs.

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 premiums and copays only

•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 (8558644028) or email (lgsseizures@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 2036141713

Enrollment Forms

Enrollment Form