PAF Co-Pay Relief: Neoplasm Related Pain
Not Funded
About
The PAF Co-Pay Relief: Neoplasm Related Pain program offers vital support for patients seeking help with medication costs associated with approved neoplasm-related treatments. This program, covering a wide range of drugs such as Adcetris, Afinitor, and others, ensures patients can receive necessary financial assistance to manage their healthcare expenses effectively. The PAF Co-Pay Relief program guarantees swift funding once applications are approved, helping patients alleviate the financial burden of drug therapies for critical conditions.
Insurance requirements: Commercially insured, Medicare / Medicaid
Enrollment Forms
Enrollment Form
Benefits
•$3000 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 may complete the application online or by phone; once approved, patients will begin receiving funding immediately
•All patients approved for assistance are required to have their diagnosis and treatment verified by a member of the patient’s care team within 30 days of approval
•The CoPay Relief Program will confirm the patient's reported income to ensure that it is within the income eligibility guidelines for the program through an income verification screening process
•If patient's reported income is unable to be verified, a letter will be sent requesting proof of income documents be submitted to our program within 30 days for continued eligibility. Approved patients who do not comply with the request for income documentation within 30 days will forfeit their award
•Approved patients who have a household income in excess of program guidelines upon review of submitted income documentation will no longer qualify for continued support, will forfeit their award and will not be eligible to reapply for the program until 12 months from the original date of approval
•Approved patients understand and agree that if they do not comply with the request for income documentation will no longer qualify for continued support, will forfeit their award and will not be eligible to reapply for the program until 12 months from the original date of approval
•Patients can continue to submit claims for payment during this income verification period
•Claims can be submitted to CPR for payment via Virtual Pharmacy Card, electronic upload into the portal, faxed using the unique barcoded fax cover sheet or mailed
•Claims can be paid via Virtual Pharmacy Card, Electronic Funds Transfer (EFT) or check
•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. Uninsured patients are ineligible UNLESS they have had coverage within the previous 6 months
•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
Enrollment Forms
Enrollment Form