Submit an inquiry
Contact Us - revised
Contact us by phone, mail, or fax
To mail documents related to your grant application, submit a claim, donate by mail, or contact our headquarters, review the below information carefully to ensure your request is routed to the right place.
-
The quickest way to apply for a grant is through our patient, provider, or pharmacy portal. To apply by mail or fax, complete this form and send the application to:
PAN Foundation
P.O. Box 30500
Bethesda, MD 20824
Fax: 1-866-316-7261If you have questions about your application that are not answered in our FAQs, call us at 1-866-316-7263 from Monday through Friday, 9:00 a.m. to 5:30 p.m. ET.
-
If you’ve been asked to submit income verification documents, verify your income online, or mail or fax your materials to the following address or fax number:
PAN Foundation
P.O. Box 30500
Bethesda, MD 20824
Fax: 1-866-316-7261If you have questions related to income verification, call us at 1-866-316-7263 from Monday through Friday, 9:00 a.m. to 5:30 p.m. ET.
-
If you have been asked to verify your insurance information or premium amount, you can use this form to submit your document online, or mail or fax your materials to the following address or fax number:
PAN Foundation
P.O. Box 30500
Bethesda, MD 20824
Fax: 1-866-316-7261If you have questions related to premium income verification, call us at 1-866-316-7263 from Monday through Friday, 9:00 a.m. to 5:30 p.m. ET.
-
To donate to the PAN Foundation by mail, please mail your gift to:
Patient Access Network Foundation
PO Box 716408
Philadelphia, PA 19171Make your check or money order payable the PAN Foundation and include how you would like your donation designated in the memo line. If none is provided, we will gladly direct your donation where needed most.
-
Do you need to file a claim? If you’re a patient, complete the direct reimbursement form and mail or fax the required documents to the address below.
If you’re a healthcare provider, the quickest way to file a claim is through the provider portal. If you’d still prefer to submit by mail, review our claims FAQs for all the information you need and send your documents to the following address:
PAN Foundation
P.O. Box 2310
Mt. Clemens, MI 48046
Fax: 1-844-726-4728If you have questions related to claims, call us at 1-866-316-7263 from Monday through Friday, 9:00 a.m. to 5:30 p.m. ET.
-
A confidential compliance hotline is available for individuals to report fraud, waste or abuse concerns and issues anonymously. Please include the PAN Foundation as the company name with your report.
- Call the hotline: 877-210-0006
- Submit a fax: 215-689-3885
- Send an email
- Submit online
- Download the smartphone app: The Anonymous Reporting app is available in the Apple App Store and Google Play Store. On the app, use the keyword panfoundation to save and submit your report.
-
Get in touch with our team or send mail to our headquarters. Note: Use the above contact form to submit questions relating to disease funds, medications, and claims or media, partnership, and vendor inquiries.
PAN Foundation
805 15th Street, NW, Suite 500
Washington, DC 20005
Phone: 800-394-0161