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Arrhythmia in Patients with Atrial Fibrillation or Atrial Flutter

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Program Status

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Renewal Only - We are accepting applications for renewal patients only. If your renewal application for assistance is approved, you can begin receiving funding immediately.

Assistance Amount

$1,500 per year. Patients may apply for a second grant during their eligibility period subject to availability of funding.

 

Eligibility Criteria

  1. The patient must be getting treatment for the disease named in the assistance program to which he or she is applying.
  2. The patient must have Medicare health insurance that covers his or her qualifying medication or product. 
  3. The patient’s medication or product must be listed on PAN’s list of covered medications.
  4. The patient’s income must fall at or below 400% the Federal Poverty Level.
  5. The patient must reside and receive treatment in the United States or U.S. territories. (U.S. citizenship is not a requirement.)
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See the list of medications covered in this program
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  • Amiodarone Hcl (amiodarone hcl)
  • Atenolol (atenolol)
  • Betapace (sotalol hcl)
  • Bisoprolol Fumarate (bisoprolol fumarate)
  • Brevibloc (esmolol hcl in sodium chloride, iso-osmotic)
  • Brevibloc (esmolol hcl)
  • Calan Sr (verapamil hcl)
  • Cardizem La (diltiazem hcl)
  • Cartia Xt (diltiazem hcl)
  • Carvedilol (carvedilol)
  • Cordarone (amiodarone hcl)
  • Coreg Cr (carvedilol phosphate)
  • Corgard (nadolol)
  • Corvert (ibutilide fumarate)
  • Digitek (digoxin)
  • Digoxin (digoxin)
  • Dilacor Xr (diltiazem hcl)
  • Dilt-Cd (diltiazem hcl)
  • Diltia Xt (diltiazem hcl)
  • Diltiazem Hcl (diltiazem hcl)
  • Diltzac Er (diltiazem hcl)
  • Disopyramide Phosphate (disopyramide phosphate)
  • Dofetilide (dofetilide)
  • Esmolol Hcl (esmolol hcl)
  • Flecainide Acetate (flecainide acetate)
  • Hemangeol (propranolol hcl)
  • Ibutilide Fumarate (ibutilide fumarate)
  • Inderal La (propranolol hcl)
  • Innopran Xl (propranolol hcl)
  • Lanoxin (digoxin)
  • Lopressor (metoprolol tartrate)
  • Matzim La (diltiazem hcl)
  • Metoprolol Succinate (metoprolol succinate)
  • Metoprolol Tartrate (metoprolol tartrate)
  • Multaq (dronedarone hcl)
  • Nadolol (nadolol)
  • Nexterone (amiodarone in dextrose, iso-osmotic)
  • Norpace Cr (disopyramide phosphate)
  • Pacerone (amiodarone hcl)
  • Procainamide Hcl (procainamide hcl)
  • Propafenone Hcl Er (propafenone hcl)
  • Propranolol Hcl (propranolol hcl)
  • Quinidine Gluconate (quinidine gluconate)
  • Quinidine Sulfate (quinidine sulfate)
  • Rythmol (propafenone hcl)
  • Sorine (sotalol hcl)
  • Sotalol (sotalol hcl)
  • Sotylize (sotalol hcl)
  • Tambocor (flecainide acetate)
  • Taztia Xt (diltiazem hcl)
  • Tenormin (atenolol)
  • Tiazac (diltiazem hcl)
  • Tikosyn (dofetilide)
  • Toprol Xl (metoprolol succinate)
  • Verapamil Er (verapamil hcl)
  • Verelan (verapamil hcl)
  • Zebeta (bisoprolol fumarate)