|Maximum Award Level||Pharmacy Card Fund|
Minimum Copay Reimbursement Amount
|Household Income Limit|
|400% of the Federal Poverty Level (adjusted for household size and high cost of living areas)|
Consider Premium Assistance
Under this fund, HealthWell can assist with premium costs. Medicare supplemental policies can help with cost shares related to many aspects of your health care. Using a HealthWell grant to cover premiums may be a better option than treatment-specific cost shares.
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 Diseases and Medications 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.) that covers part of the cost of your treatment. The Foundation will refer patients without prescription insurance to other programs, such as manufacturer patient assistance programs.
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 Macular Degeneration
Macular Degeneration is caused by the deterioration of the central portion of the retina, the inside back layer of the eye that records the images we see and sends them via the optic nerve from the eye to the brain. The retina’s central portion, known as the macula, is responsible for focusing central vision in the eye, and it controls our ability to read, drive a car, recognize faces or colors, and see objects in fine detail. Source: American Macular Degeneration Foundation, National Eye Institute
|Macular Degeneration Association|
|National Eye Institute|
You may also visit our Resource List to view other copayment organizations that may provide assistance.