Ella Walter
The PAN Foundation is a charitable patient assistance organisation that helps people cover the costs of prescription medications. It provides financial assistance to patients with life-threatening, chronic, and rare diseases, helping them to afford their out-of-pocket medication costs. The PAN Foundation also offers grants to cover insurance premiums and transportation expenses. The grants are available for a 12-month period and can be renewed or extended with additional funding. The PAN Foundation also provides information about the Social Security Administration's Extra Help program, which helps people with Medicare drug plans cover the costs of their prescription medications.
| Characteristics | Values |
|---|---|
| Type of Organization | Charitable patient assistance foundation |
| Type of Assistance | Financial assistance |
| Who They Help | Patients living with life-threatening, chronic, and rare diseases |
| What They Pay For | Out-of-pocket prescription medication costs, other types of financial assistance, referrals to other patient support organizations, patient advocacy, and education |
| Number of Diseases Covered | More than 80 |
| Grant Types | Co-pay grants, health insurance premium grants, and transportation grants |
| Grant Period | 12 months |
| Compliance | In full compliance with all relevant laws, regulations, and government guidelines |
What You'll Learn
Out-of-pocket medication costs
The PAN Foundation offers copay grants to help cover out-of-pocket medication costs. These grants are available for a 12-month period and can be used to cover the costs of prescription medications for various disease diagnoses, including generic or bioequivalent drugs. The grants do not cover medications that are not listed in the formulary for your disease fund or medications already paid for by health insurance.
To be eligible for a copay grant, applicants must meet specific criteria, including receiving treatment for the disease named in the disease fund, having the specified health insurance that covers the qualifying medication, and having an income at or below the federal poverty level specified by the disease fund. Additionally, applicants must reside and receive treatment in the United States or US territories.
The amount of copay assistance provided by the PAN Foundation varies by disease fund, and eligible individuals can choose their covered medications, providers, and pharmacies. The PAN Foundation also offers additional funding and renewal grants for active grant recipients who need further support.
In addition to the copay grants, the PAN Foundation also provides information about the Extra Help program, also known as the Low-Income Subsidy, offered by the Social Security Administration. This program assists individuals with limited income and assets in paying for the monthly premiums, annual deductibles, and copays related to their prescription medications. While the Extra Help program does not cover all out-of-pocket costs, it can significantly reduce the financial burden, especially for those taking multiple medications.
Overall, the PAN Foundation's copay grants and the Extra Help program aim to improve access to healthcare by providing financial assistance for out-of-pocket medication costs.
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Copay grants
The PAN Foundation offers copay grants to help cover out-of-pocket medication costs. These grants are available to those who are struggling to afford their prescription medications. The grants are provided for a 12-month period, in compliance with all relevant laws, regulations, and government guidelines. If more funds are needed, applicants can apply for additional funding.
The copay grants allow recipients to choose their covered medications based on their treatment plan, as long as the medication is covered by their disease fund. The grants also allow recipients to choose their providers and pharmacies. The amount of copay assistance varies by disease fund.
To be eligible for a copay grant, applicants must meet certain criteria. They must be receiving treatment for the disease named in the disease fund or program and have the specified health insurance that covers their qualifying medication or product. The medication must be listed as covered within the disease fund the applicant is applying for. Additionally, the applicant's income must fall at or below the federal poverty level specified by the disease fund, and they must reside and receive treatment in the United States or U.S. territories.
The application process for copay grants is straightforward. Applicants can apply online or by phone. Healthcare providers and pharmacies can also apply on behalf of their patients. When applying, applicants should have the following information ready: their diagnosis and medications, health insurance carrier and insurance member ID, personal and contact information, provider's contact information, and information on their adjusted gross annual household income.
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Health insurance premiums
The PAN Foundation's health insurance premium grants are designed to alleviate the financial burden of monthly insurance payments for individuals seeking medical treatment. By offering these grants, the foundation ensures that patients can access the necessary healthcare services without being hindered by high out-of-pocket costs.
To be eligible for a health insurance premium grant from the PAN Foundation, individuals must meet specific criteria. Firstly, they should be undergoing treatment for a disease named in the disease fund or program offered by the foundation. The availability of grants is dependent on the specific disease fund being open for applications. Additionally, applicants must have health insurance that covers their qualifying medication or product, and their prescribed medication must be listed as covered within the disease fund they intend to apply for.
The PAN Foundation's health insurance premium grants are typically provided for a 12-month period, adhering to all relevant laws, regulations, and government guidelines. The amount of assistance and eligibility requirements can vary based on the particular disease fund. It is important to note that health insurance premium grants from the PAN Foundation may not be available in all locations, and interested individuals should check the eligibility criteria for their specific disease fund.
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Transportation grants
The PAN Foundation's transportation grants provide financial support to patients with life-threatening, chronic, and rare diseases. These grants help patients access affordable and reliable transportation to and from activities that improve their overall health outcomes. This includes healthcare services, social connection and support, and access to healthy and nutritious food.
To be eligible for a transportation grant, patients must already have a current copay or health insurance premium grant and must be receiving treatment for the disease named in the disease fund or program. Additionally, patients must have health insurance that covers their qualifying medication or product, and their income must be at or below the federal poverty level specified by the disease fund. Only patients residing and receiving treatment in the United States or US territories are eligible for transportation grants, and US citizenship is not a requirement.
The transportation grant is provided in the form of a $500 prepaid Visa debit card, which can be used to cover various transportation expenses. Covered expenses include gas, parking, public transportation, taxis, airfare, car rentals, lodging, non-emergency medical transportation, and ridesharing services. It is important to note that the grant only covers travel costs and not the purchase of goods or other non-transportation-related services.
To apply for a transportation grant, patients can check their eligibility and apply online through their PAN portal account or by calling the PAN Foundation at 1-866-316-7263 during business hours on weekdays.
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Extra Help program
The Extra Help program, also known as the Low-Income Subsidy (LIS), is a federal program that helps people on Medicare drug plans with limited incomes and assets pay for the monthly premiums, annual deductibles, and copays related to their prescription medications. While the program may not cover all out-of-pocket costs, it can significantly reduce what you pay for your medications, especially if you take multiple medications.
People eligible for Extra Help in 2024 have less than $22,590 in individual annual income ($1,883 per month) or less than $30,660 in annual income as a couple ($2,555 per month). There are no premiums for Part D drug plans, and individuals will pay no more than $11.20 in 2024 for each brand-name drug the plan covers and $4.50 for generic medications.
To qualify for Extra Help, your income must be less than 150 percent of the federal poverty level, and total resources or assets must be at or below the specified amounts. These figures may change each year. Income limits are higher in Alaska and Hawaii. If you or your spouse work or support other family members who live with you, you may qualify for benefits even if your income is higher than the amounts listed above. Assets include money in a checking, savings, or retirement account, as well as stocks and bonds.
Some people get Part D Extra Help automatically. You do not need to apply for Extra Help if you are enrolled in both Medicaid and Medicare, receive Supplemental Security Income (SSI), or qualify for a Medicare Savings Program. If you fall into one of these categories, you are automatically enrolled.
If you want to apply for the Extra Help program, you can contact the Social Security Administration, which operates the program. You can call 1-800-772-1213 (TTY 1-800-325-0778) or visit their website. State Health Insurance Assistance Programs (SHIPs) also provide free help to people with Medicare and their families, including assistance with applying to the Extra Help program. You can call them toll-free at 877-839-2675 or visit their website.
It is important to note that you will need to continue meeting the eligibility requirements to stay enrolled in the Extra Help program each year.
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Frequently asked questions
The PAN Foundation helps cover out-of-pocket medication costs, copays, health insurance premiums, and transportation expenses.
Copay grants from the PAN Foundation offer funds to cover out-of-pocket medication costs. The grants are provided for a 12-month period and cover prescription medications for each diagnosis if they meet certain criteria.
The medications must be:
- Listed in official compendia.
- Listed in published evidence-based or clinical guidelines.
The PAN Foundation does not cover:
- Medications or over-the-counter products that are not covered by your insurance.
- Medications not listed in the formulary for your disease fund.
- Medications already paid 100% by your health insurance.
- Medications billed only to drug discount cards.
- Medical services and office visits.
Transportation grants help PAN patients pay for transportation to and from activities that improve their overall health, including transportation to and from grocery stores, pharmacies, medical appointments, and social support.
