PAN: Waldenstrom Macroglobulinemia

Funded
About
The PAN: Waldenstrom Macroglobulinemia program offers essential financial assistance for patients receiving treatment for Waldenstrom Macroglobulinemia using a wide range of medications, including Afinitor, Imbruvica, and Velcade. This program ensures quick eligibility determination, provides a 12-month assistance period, and allows for the submission of eligible expenses for reimbursement. With benefits like automatic renewal applications and comprehensive support for those below 500% of the Federal Poverty Level, the PAN: Waldenstrom Macroglobulinemia program is a vital resource for patients navigating their treatment journey.
Insurance requirements: Commercially insured, Medicare / Medicaid
Enrollment Forms
Enrollment Form
Benefits
•$2000 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 that this fund may cover offlabel drugs
•Patients can either call (18663167263) or apply through selfservice patient portal
•Provided patient completes application on self service portal or over the phone, eligibility determination takes less than one minute
•Portal/representative will provide enrollment dates, the patient's PAN I.D. number and the available grant balance, allowing for medications to be dispensed
•Patients will also receive approval letter and plastic pharmacy card within one week (provider will also receive letter)
•Assistance begins on approval date and continues for 12 months
•During initial eligibility period, eligible expenses incurred up to 90 days prior to approval date may also be submitted for reimbursement
•All eligible expenses must be submitted within 120 days of the eligibility end date
•Payment can be made to the patient, physician, pharmacy or health care provider
•Patients are eligible for renewal at the end of their eligibility period if funds are available
•Foundation will send a renewal application automatically if the program is accepting renewal patients
•Patient may apply for a second grant during their eligibility period subject to availability of funding
•Diagnosis Codes: ICD10: C88.00, C88.01