Currently Closed – We are no longer accepting or processing applications for new or renewal patients.
$2,000 per year. Patients may apply for a second grant during their eligibility period subject to availability of funding.
- The patient must be getting treatment for the disease named in the assistance program to which he or she is applying.
- The patient must have Medicare health insurance that covers his or her qualifying medication or product.
- The patient’s medication or product must be listed on PAN’s list of covered medications.
- The patient’s income must fall at or below 500% of the Federal Poverty Level.
- The patient must reside and receive treatment in the United States or U.S. territories. (U.S. citizenship is not a requirement.)
See the list of medications covered in this program
- Avastin (bevacizumab)
- Eylea (aflibercept)
- Iluvien (fluocinolone acetonide)
- Jetrea (ocriplasmin/pf)
- Lucentis (ranibizumab)
- Macugen (pegaptanib sodium)
- Ozurdex (dexamethasone)
- Retisert (fluocinolone acetonide)
- Triesence (triamcinolone acetonide/pf)
- Visudyne (verteporfin)
ICD-10: E08.311, E08.321, E08.3211-E08.3213, E08.3219, E08.331-E08.3313, E08.3319, E08.341-E08.3413, E08.3419, E08.351-E08.3513, E08.3519, E08.3521-E08.3523, E08.3529, E09.311, E09.321-E09.3213, E09.3219, E09.331, E09.3313, E09.3319, E09.341-E09.3413, E09.3419, E09.351-E09.3513, E09.3519, E09.3521-E09.3523, E09.3529, E09.37X1-E09.37X3, E09.37X9, E10.311, E10.321-E10.3213, E10.3219, E10.331-E10.3313, E10.3319, E10.341-E10.3413, E10.3419, E10.351-E10.3513, E10.3519, E10.3521-E10.3523, E10.3529, E10.37X1-E10.37X3, E10.37X9, E11.311, E11.321-E11.3213, E11.3219, E11.331-E11.3313, E11.3319, E11.341-E11.3413, E11.3419, E11.351-E11.3513, E11.3519, E11.3521-E11.3523, E11.3529, E11.37X1-E11.37X3, E11.37X9, E13.3211-E13.3213, E13.3219, E13.3311-E13.3313, E13.3319, E13.3411-E13.3413, E13.3419, E13.3511-E13.3513, E13.3519, E13.3521-E13.3523, E13.3529, E13.37X1-E13.37X3, E13.37X9, H35.30-H35.3114, H35.3120-H35.3124, H35.3130-H35.3134, H35.3190-H35.3194, H35.32-H35.3213, H35.3220-H35.3223, H35.3230-H35.3233, H35.3290-H35.3293, H35.33, H35.341-H35.343, H35.349, H35.351-H35.353, H35.359, H35.361-H35.363, H35.369, H35.371-H35.373, H35.379, H43.821-H43.823, H43.829, H43.829