Alagille Syndrome Vitamins and Supplements

Status

Open

Fund Type

Copay

Maximum Award Level

$1,500

Pharmacy Card Fund

Yes

Minimum Copay
Reimbursement Amount

Minimum Copay Reimbursement Amount

We encourage you to please use your HealthWell pharmacy card for any applicable charges as possible.

None

Minimum Premium
Reimbursement Amount

Minimum Premium Reimbursement Amount

We encourage you to please submit monthly reimbursement claims (even if your premium is paid on a bi-weekly basis).

None

Household Income Limit

500% of the Federal Poverty Level
(adjusted for household size and high
cost of living areas)

Fund Alerts

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Treatments Covered

Infant Formulas
  • Alfamino (all Varieties)
  • Alimentum (all Varieties)*
  • Elacare (all Varieties)
  • Enfamil (all Varieties)
  • Enfaport (all Varieties)*
  • Gerber Good Start (all Varieties)
  • High Mct Formulas (all Varieties)*
  • Monogen (all Varieties)*
  • Neocate Formula (all Varieties)
  • Nutramigen (all Varieties)*
  • Pediasure Peptide (all Varieties)*
  • Pregestimil (all Varieties)*
  • Puramino (all Varieties)*
  • Similac (all Varieties)
Oral/Tube Feeding Supplements
  • Boost (all Varieties)
  • Kate Farms (all Varieties)
  • Lutrish (all Varieties)
  • Mct Oil (all Varieties)*
  • Pediasure (all Varieties)
  • Peptamen (all Varieties)
Vitamins
  • Deka (plus And Essentials)*
  • Mvw Adek Gummies*
  • Mvw Complete Formulation (adult And Kids)*
  • Vitamin A (all Varieties)*
  • Vitamin C (all Varieties)*
  • Vitamin D (all Varieties)*
  • Vitamin E (all Varieties)*
  • Vitamin K (all Varieties)*

*These products are not billable through HealthWell’s pharmacy card. Please submit requests for reimbursement through our paper claim process.

Fund Definition

Assistance with vitamins and supplements formulated to support treatment and management of Alagille Syndrome.

Grant Utilization

HealthWell estimates that patients use an average of $610 during their 12-month grant period for this disease area.

About Our Alagille Syndrome Vitamins and Supplements Fund

HealthWell’s Alagille Syndrome Vitamins and Supplements Fund is designed to assist eligible people living with Alagille Syndrome with the full or partial cost-shares associated with vitamins and supplements. We are committed to supporting the ALGS community and the established guidelines around our covered product list are meant to focus on the areas of greatest need for the majority of people living with ALGS. We understand there are additional areas to be addressed and, over time, it is our hope to be able to expand our coverage even further.

Please note that we are not able to assist with special requests outside of our covered product list at this time.

Do I Qualify?

HealthWell bases eligibility on an individual’s medical, financial and insurance situation. To qualify for HealthWell’s assistance, applicants must meet the following eligibility requirements:

  • Please make sure that HealthWell currently has a fund for your diagnosis/indication and that your medication is covered under that fund by visiting our Disease Funds listing. If we do not have a fund that currently covers your diagnosis, please check back as we frequently open and reopen programs as funding becomes available. The Foundation is able to help patients receiving treatment for indications for which we currently have an open fund. We can only assist with medications that have been prescribed to treat the disease/covered diagnosis. You will be asked to provide the Foundation with the patient’s diagnosis, which must be verified by a physician, nurse practitioner, or physician assistant’s signature. The patient must receive treatment in the United States.

  • To qualify for assistance from HealthWell, you must have some form of health insurance (private insurance, Medicare, Medicaid, TriCare, etc.). For our Alagille Syndrome Vitamins and Supplements Fund, we understand that your insurance may not cover the cost of your vitamins and supplements.

  • HealthWell assists individuals with incomes up to 300-500% of the Federal Poverty Level. The Foundation also considers the number in a household and cost of living in a particular city or state. If you believe you qualify for assistance, you may begin the application process here.

  • If you are receiving treatment in the U.S. and have met the eligibility criteria as listed, you are ready to apply! Please note that you will be asked to provide a Social Security Number in order to create a grant. This information is gathered to eliminate duplicate applications and is kept secure and confidential.

About Alagille Syndrome

Alagille syndrome (ALGS) is a rare genetic disorder that can affect multiple organ systems of the body including the liver, heart, skeleton, eyes and kidneys. The specific symptoms and severity of ALGS can vary greatly from one person to another. Some individuals may have a mild form of the disorder that can virtually go unnoticed, while others may have a serious form of the disorder that can potentially cause life-threatening complications. Common symptoms, which often develop during the first three months of life, include blockage of the flow of bile from the liver (cholestasis), yellowing of the skin and mucous membranes (jaundice), poor weight gain and growth, severe itching (pruritis) and pale, loose stools. Because the body cannot properly absorb fats and fat-soluble vitamins (vitamins A, D, E, and K), affected children may also experience growth deficiencies and failure to thrive. Malabsorption of vital nutrients can also lead to other conditions such as rickets, vision problems, poor coordination and developmental delays, and blood clotting problems. Source: Alagille Syndrome Alliance

Additional Educational Resources

You may also visit our Resource List to view other copayment organizations that may provide assistance.