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Mantle Cell Lymphoma

Get Help with Your Treatment

Apply Online or call 1-866-316-7263

 

Program Status

Open - We are accepting applications for new and renewal patients. If your application for assistance is approved you can begin receiving funding immediately.

 

 

Assistance Amount

$8,400 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 mantle cell lymphoma.
  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 500% of 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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  • Active Injection Kit D (dexamethasone sodium phosphate/pf)
  • Adriamycin (doxorubicin hcl)
  • A-Methapred (methylprednisolone sodium succinate)
  • Bendeka (bendamustine hcl)
  • Betamethasone Acetate-Sod Phos (betamethasone acetate and sodium phos in sterile water/pf)
  • Betamethasone Acetate-Sod Phos (betamethasone acetate/betamethasone sodium phosphate)
  • Bicnu (carmustine)
  • Calcium Folinate (leucovorin calcium)
  • Calquence (acalabrutinib)
  • Carboplatin (carboplatin)
  • Cisplatin (cisplatin)
  • Cladribine (cladribine)
  • Cyclophosphamide (cyclophosphamide)
  • Cytarabine (cytarabine/pf)
  • Deltasone (prednisone)
  • Dexamethasone Intensol (dexamethasone)
  • Dexpak (dexamethasone)
  • Doubledex (dexamethasone sodium phosphate/pf)
  • Doxorubicin Hcl (doxorubicin hcl)
  • Eloxatin (oxaliplatin)
  • Etopophos (etoposide phosphate)
  • Etoposide (etoposide)
  • Fludarabine Phosphate (fludarabine phosphate)
  • Gemcitabine Hcl (gemcitabine hcl)
  • Gemzar (gemcitabine hcl)
  • Ifex (ifosfamide)
  • Ifosfamide (ifosfamide)
  • Ifosfamide-Mesna (ifosfamide/mesna)
  • Imbruvica (ibrutinib)
  • Leucovorin Calcium (leucovorin calcium)
  • Matulane (procarbazine hcl)
  • Mesna (mesna)
  • Methotrexate (methotrexate sodium)
  • Methylprednisolone (methylprednisolone)
  • Mitoxantrone Hcl (mitoxantrone hcl)
  • Nipent (pentostatin)
  • Oxaliplatin (oxaliplatin)
  • Pentostatin (pentostatin)
  • Prednisone (prednisone)
  • Rayos (prednisone)
  • Revlimid (lenalidomide)
  • Rituxan (rituximab)
  • Solu-Medrol (methylprednisolone sodium succinate/pf)
  • Toposar (etoposide)
  • Treanda (bendamustine hcl)
  • Triamcinolone Acetonide (triamcinolone acetonide)
  • Triamcinolone Diacetate (triamcinolone diacetate in 0.9 % sodium chloride)
  • Velcade (bortezomib)
  • Vincasar Pfs (vincristine sulfate)
  • Vincristine Sulfate (vincristine sulfate)

Diagnosis Codes:

ICD-10: C83.10-C83.19