Back to Top

Uveitis

Get Help with Your Treatment

Apply Online or call 1-866-316-7263

 

Program Status

Program Open

Currently Closed – We are no longer accepting or processing applications for new or renewal patients.

 

The PAN Foundation’s Uveitis fund is currently closed. As of December 6, 2017, The Assistance Fund is accepting applications.

Assistance Amount

$600 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 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% 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.)
list icon
See the list of medications covered in this program
View List  
  • A-Hydrocort (hydrocortisone sod succinate)
  • A-Methapred (methylprednisolone sodium succinate)
  • Atropine Care (atropine sulfate)
  • Atropine Sulfate (atropine sulfate)
  • Betamethasone Acetate-Sod Phos (betamethasone acetate/betamethasone sodium phosphate)
  • Blephamide (sulfacetamide sodium/prednisolone acetate)
  • Celestone (betamethasone acetate/betamethasone sodium phosphate)
  • Cellcept (mycophenolate mofetil)
  • Cortef (hydrocortisone)
  • Cortisone Acetate (cortisone acetate)
  • Cortisporin (neomycin/bacitracin/polymyxin b/hydrocortisone)
  • Cyclogyl (cyclopentolate hcl)
  • Cyclopentolate Hcl (cyclopentolate hcl)
  • Deltasone (prednisone)
  • Depo-Medrol (methylprednisolone acetate)
  • Durezol (difluprednate)
  • Flarex (fluorometholone acetate)
  • Flo-Pred (prednisolone acetate)
  • Fluorometholone (fluorometholone)
  • Fml (fluorometholone)
  • Fml Forte (fluorometholone)
  • Homatropaire (homatropine hbr)
  • Homatropine Hydrobromide (homatropine hbr)
  • Humira (adalimumab)
  • Hydrocortisone (hydrocortisone)
  • Inflectra (infliximab-dyyb)
  • Isopto Atropine (atropine sulfate)
  • Leukeran (chlorambucil)
  • Maxitrol (neomycin/polymyxin b sulfate/dexamethasone)
  • Methotrexate Sodium (methotrexate sodium/pf)
  • Methylprednisolone (methylprednisolone)
  • Millipred (prednisolone)
  • Mycophenolate Mofetil (mycophenolate mofetil)
  • Neomycin-Bacitracin-Poly-Hc (neomycin sulfate/bacitracin zinc/polymyxin b/hydrocortisone)
  • Neomycin-Polymyxin-Dexameth (neomycin/polymyxin b sulfate/dexamethasone)
  • Neomycin-Polymyxin-Hc (neomycin sulfate/polymyxin b sulfate/hydrocortisone)
  • Neo-Polycin Hc (neomycin sulfate/bacitracin zinc/polymyxin b/hydrocortisone)
  • Omnipred (prednisolone acetate)
  • Orapred Odt (prednisolone sod phosphate)
  • Ozurdex (dexamethasone)
  • Pediapred (prednisolone sod phosphate)
  • Pred Forte (prednisolone acetate)
  • Pred Mild (prednisolone acetate)
  • Pred-G (gentamicin sulfate/prednisolone acetate)
  • Prednisolone (prednisolone)
  • Prednisone (prednisone)
  • Prelone (prednisolone)
  • Rayos (prednisone)
  • Remicade (infliximab)
  • Restasis Multidose (cyclosporine)
  • Retisert (fluocinolone acetonide)
  • Solu-Cortef (hydrocortisone sodium succinate/pf)
  • Sulfacetamide-Prednisolone (sulfacetamide sodium/prednisolone sodium phosphate)
  • Tobradex (tobramycin/dexamethasone)
  • Tobramycin-Dexamethasone (tobramycin/dexamethasone)
  • Triesence (triamcinolone acetonide/pf)
  • Veripred 20 (prednisolone sod phosphate)
  • Vexol (rimexolone)
  • Zylet (tobramycin/loteprednol etabonate)

Diagnosis Codes:

ICD-10: D86.83, H20.00-H20.9, H20.051, H20.052, H20.053, H20.059, H20.10, H20.11, H20.12, H20.13, H30.001-H30.93, H30.20, H30.21, H30.22, H30.23, H30.811, H30.812, H30.813, H30.819, H44.111-H44.119, H44.131-H44.139,