PAF Co-Pay Relief: Acute Myeloid Leukemia

Funded

About

The PAF Co-Pay Relief: Acute Myeloid Leukemia program provides vital financial assistance for patients undergoing treatment with a range of FDA-approved medications such as Neupogen, Rayos, Trisenox, and others. This program supports individuals insured by Medicare, Medicaid, or Military Benefits, ensuring accessible care that enhances patient outcomes. By leveraging the PAF Co-Pay Relief: Acute Myeloid Leukemia program, patients can receive timely support and funding for their prescribed treatments, reinforcing the mission of reducing financial burdens for those battling Acute Myeloid Leukemia.

Insurance requirements: Medicare / Medicaid

Enrollment Forms

Enrollment Form

Benefits

•$4000 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

•Specific drug coverage is not indicated on program website; drug coverage must be verified by calling program at 18665123861

•Patients must submit an online application; once approved, patients will begin receiving funding immediately. Program will verify diagnosis with your treating physician within 30 days of approval. Applicants are required to be currently in treatment, planning to begin treatment in the next 60 days or has been in treatment for the past 6 months

•Assistance is awarded for a 12month period; should patients exhaust this, they must wait 12 months from the first approval date before they are eligible to reapply. Approved patients have a 6month look back period from the date of approval. Eligible claims from this 6 month period can be submitted to CPR for payment

•Approved patients who exceed 120 days with no processed claims at any time during their 12 month award period will forfeit their award. Patients who forfeit their award due to lack of utilization are not eligible to reapply for the program until 12 months from the original date of approval

•Foundation covers all drugs that are FDAindicated for the diagnosis. If physician prescribes an offlabel medication, and the insurance company will pay for it, the foundation will also cover it

•Eligible diagnosis codes: C92; C92.0C92.9; C95.00

Enrollment Forms

Enrollment Form