PAN: Short Bowel Syndrome (Premium Assistance)

Not Funded
About
The PAN: Short Bowel Syndrome (Premium Assistance) program provides valuable support for patients using Sandostatin LAR Depot, Gattex, Octreotide Acetate, Sandostatin, and Mycapssa. This program is a dedicated premium assistance initiative that offers financial relief on healthcare premiums, ensuring that patients receive comprehensive support. The PAN: Short Bowel Syndrome (Premium Assistance) scheme is designed to ease the financial burden by covering a portion of the premium associated with coverage, thereby enhancing access to essential treatments.
Insurance requirements: Commercially insured, Medicare / Medicaid
Enrollment Forms
Enrollment Form
Benefits
•$4800 annual maximum benefit
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. This fund may cover offlabel drugs
•2. This fund is for premium assistance only
•Provides assistance for the patient’s portion of the premium associated with their coverage
•This may involve an individual or family plan for those patients approved for assistance
•Once approved for program, patient will receive assistance for their full 12 months of eligibility regardless of their ongoing treatments
•Patient will not qualify for an additional year of assistance if they are not receiving treatments of a covered therapy
•Patients approved for the program can either make the payments and be reimbursed by PAN or, depending on the employer and or payor situation, PAN can make the premium payments directly to the payor
•Patient may receive grant benefits from both premium and copay programs if they meet eligibility criteria for each program
•Patients will not need to provide income documentation as part of the eligibility process, however a small number of randomly selected patients will need to provide income documentation as part of PAN's auditing process
•Patients can either call (18663167263) or apply through selfservice patient portal
•Diagnosis Codes: ICD10: K90.49, K90.89, K90.9, K91.2