NORD: Neurotrophic Keratitis (Copay)
Funded
About
The NORD: Neurotrophic Keratitis (Copay) program offers crucial financial assistance for patients diagnosed with Neurotrophic Keratitis. This program supports those prescribed Acthar Gel, Acthar Selfject, Oxervate, Betamethasone Sodium Phosphate & Betamethasone Acetate, and Purified Cortrophin Gel by helping with insurance copays. NORD ensures seamless access to these necessary treatments with quick approvals and ongoing support, enhancing patient care and financial relief.
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 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 can apply online, call (8555673680) or email (neurotrophickeratitis@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 2033493188
Enrollment Forms
Enrollment Form