Assistance Fund: Acute Myeloid Leukemia
Not Funded
About
The Assistance Fund: Acute Myeloid Leukemia program offers crucial financial support for individuals diagnosed with acute myeloid leukemia. Utilizing drugs such as Neupogen, Cytarabine, and Venclexta, this program assists with copays, coinsurance, deductibles, as well as other out-of-pocket expenses for eligible patients. By ensuring access to FDA-approved treatments and offering both copay and financial assistance, the Assistance Fund: Acute Myeloid Leukemia program aims to alleviate the financial burden on patients. Re-enrollment is required annually to continue receiving benefits.
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. Copay grant programs provide assistance for copays, coinsurance, and deductibles for FDAapproved treatment for the disease named in the disease program ONLY
•2. Financial assistance grant programs provide assistance for other eligible outofpocket costs, such as health insurance premiums and incidental medical expenses, in addition to copay, coinsurance, and deductible assistance on FDAapproved treatment for the disease named in the disease program
•3. This fund may cover offlabel drugs
•Copay and Financial assistance can be utilized by any innetwork pharmacy or site of care able to dispense the medication or provide treatment
•Program offers conditional approval of 30 days of immediate assistance for open programs where funding is available
•Patients will be asked to provide and verify demographic, insurance, and financial information (additional documentation may be requested)
•Approved patients will be granted assistance through the end of the calendar year unless otherwise specified for the applicable program
Enrollment Forms
Enrollment Form