With or without insurance, pulmonary hypertension (PH) treatments can be costly. If you are seeking help covering the co-pay for your pulmonary hypertension therapy you may wish to take some or all of the following steps. This list represents resources PHA is aware of that are likely to be applicable to many in the PH community. It is by no means an exhaustive list of state or local assistance that may be available in your area.
For recommendations about local community resources contact the Patient Advocate Foundation at (800) 532-5274.
If you believe that you are at risk for running out of your PH therapy, contact your PH care team now. Do not wait until you are completely out of medication.
Non-profit charitable assistance funds primarily support individuals with government-funded health insurance. Those with group or private insurance should also review the manufacturer assistance programs in the next tab.
PHA will continue to update this page and announce updates through PHA News, a weekly e-newsletter, if there is a change to the status of any of these funds. Sign up for PHA News here.
Nonprofit Assistance Programs:
- PAN Foundation – PH Co-Pay Assistance Fund Open at PAN Foundation
Medicare beneficiaries with pulmonary hypertension (PH) can apply for a co-pay assistance grant up to $5,300 from the PAN Foundation. Apply via the PAN Foundation’s website at https://www.panapply.org/ or call 866-316-7263.
- The Assistance Fund – The Assistance Fund has re-opened their copay grant program for pulmonary hypertension. Apply at https://tafcares.org/program-listing/ or by calling (855) 649-8623. This program accepts applicants with all health insurance types.
- Good Days – not currently accepting applications.
- Patient Advocate Foundation – not currently accepting applications.
- Patient Services Inc – not currently accepting applications.
Parents and guardians whose minor children have pulmonary hypertension (PH) should be aware of the pediatric assistance fund at the HealthWell Foundation. The fund assists with co-pay or other costs related to a child’s life-altering medical condition. Applications are considered on a case-by-case basis and there is no online application. Interested families should contact the HealthWell Foundation at 1-800-675-8416. Additional guidelines are available at https://www.healthwellfoundation.org/fund/pediatric-assistance/
PLEASE NOTE: At this time the HealthWell Foundation does not offer financial assistance for adults taking pulmonary hypertension medications. For a list of HealthWell’s assistance funds for adults, please visit https://www.healthwellfoundation.org/disease-funds/?fund_status=open
Many pharmaceutical companies or specialty pharmacies sponsor drug-specific assistance programs to help patients navigate the reimbursement process.
PAPs are designed to make it as easy as possible to get your treatment by providing free or discounted drugs to low-income, underinsured or uninsured patients who meet specific guidelines. Manufacturers may also offer other types of general support programs, providing additional education, support and financial assistance.
Companies update these programs on an ongoing basis so individuals seeking assistance may wish to call even if they do not expect to qualify.
After exploring the options above, consider contacting the specialty pharmacy that delivers your PH medication.
- Accredo/CuraScript/ExpressScripts: 1-866-FightPH (1-866-344-4874)
- Cigna Tel-Drug: 1-855-326-7463
- CVS/Caremark: 1-877-242-2738
- Humana Specialty Pharmacy: 1-855-478-8405
- Briova/OptumRx: 1-855-856-0536
- Walgreens/Medmark: 1-888-347-3416
Your state legislators and your U.S. senators and representative are all potential sources of help and information. They may be familiar with state-specific financial assistance resources for medication costs or other types of expenses.
- To contact your U.S. senators and representative, visit PHA’s action alert.
- To contact state legislators, visit your legislature’s website: https://www.congress.gov/state-legislature-websites
Medicare Extra Help: If you use Medicare, you may wish to explore a program called “Medicare Extra Help” which provides reduced prescription drug costs for low-income Medicare recipients.
- To apply online, visit: https://secure.ssa.gov/i1020/start
- To apply by telephone, mail a paper application, or make an appointment at the local SSA office, call 1-800-772-1213 (TTY users should call 1-800-325-0778)
www.Benefits.gov and your state website (usually www.statename.gov) have additional information about government-funded assistance programs. For example, Medicaid, the Children’s Health Insurance Program (CHIP), rent and utility assistance, child care assistance and supplemental income.
The following organizations advertise resources that may help individuals impacted by PH cover expenses other than medication copays.
- Blue Lips Foundation – grants for non-medical expenses.
- Genetic and Rare Diseases Information Center – list of programs that help with the costs of medical travel.
- Keep Swimming Foundation – grants to the families of individuals facing extended hospital stays.
- Patient Advocate Foundation – insurance navigation assistance; national directory of financial resources; case management and support.
- Unmet Needs Patient Impact Fund – grants for non-medical expenses.