NORD: Paroxysmal Nocturnal Hemoglobinuria (PNH) (Medical Assistance)

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About

The NORD: Paroxysmal Nocturnal Hemoglobinuria (PNH) (Medical Assistance) program offers essential medical support for patients diagnosed with Paroxysmal Nocturnal Hemoglobinuria. With coverage potentially including drugs like Xarelto, Soliris, and Empaveli, the program is designed to assist uninsured or underinsured US residents. It provides efficient enrollment procedures, including online applications and same day approvals, enhancing access to necessary treatments and improving patient outcomes.

Insurance requirements: Underinsured, Uninsured

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 medical assistance 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 can apply online, call (8555673814) or email (pnh@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 2035174297

Enrollment Forms

Enrollment Form

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