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For immediate receipt, upload your documents thru HealthWell’s Pharmacy and Provider portals. You may also fax your documents to us at 800-282-7692.
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Melanoma - Medicare Access (Medicare patients only)



Fund Type


Maximum Award Level


Pharmacy Card Fund


Household Income Limit

400% of the Federal Poverty Level
(adjusted for household size and high cost of living areas)

Treatments Covered

  • Aldesleukin
  • Amascrine
  • Amifostine
  • Amonafide
  • Amsacrine
  • Avastin
  • Azelaic Acid
  • Azelex
  • Baccilus Of Calmette And Guerin
  • Bevacizumab
  • Bevacizumab-awwb
  • Bleomycin Sulfate
  • Braftovi
  • Braftovi + Mektovi
  • Brequinar
  • Bryostatin-1
  • Carboplatin
  • Carmustine
  • Cimetidine
  • Cisplatin
  • Cotellic
  • Dabrafenib
  • Dabrafenib Mesylate
  • Dacarbazine
  • Dactinomycin
  • Decitabine
  • Doxil
  • Droxia
  • Dtic-dome
  • Fenretinide
  • Fotemustine
  • Hydrea
  • Hydroxyurea
  • Imatinib
  • Imlygic
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Beta
  • Interleukin-4
  • Interleukin-6
  • Intron A
  • Iodine-125
  • Ipilimumab
  • Isotretinoin
  • Keytruda
  • Leukine
  • Lomustine
  • Marimastat
  • Masoprocol
  • Megestrol
  • Megestrol Acetate
  • Mekinist
  • Mektovi
  • Melphalan Hydrochloride
  • Mvasi
  • Nexavar
  • Oblimersen
  • Opdivo
  • Paclitaxel
  • Palladium Pd 103
  • Peginterferon Alfa-2b
  • Pegintron
  • Peplomycin
  • Piritrexim
  • Platinol
  • Platinol-aq
  • Proleukin
  • Ranitidine
  • Ranitidine Hydrochloride
  • Recombinant Interferon Alfa
  • Sorafenib
  • Sylatron
  • Tafinlar
  • Tamoxifen
  • Tasonermin
  • Taxol
  • Taxotere
  • Temozolomide
  • Temsirolimus
  • Thymalfasin
  • Thymopentin
  • Tirapazamine
  • Torisel
  • Trametinib
  • Trametinib Dimethyl Sulfoxide
  • Treosulfan
  • Tretinoin
  • Trimetrexate
  • Vemurafenib
  • Vinblastine Sulfate
  • Vincristine Sulfate
  • Vindesine
  • Yervoy
  • Zelboraf

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:

  • 1.You are being treated for Melanoma.

    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.

  • 2.You have Medicare.

    This is a Medicare Access Fund. In order to qualify for assistance through this fund, you must have Medicare. The Foundation will refer patients without Medicare to other programs, such as manufacturer patient assistance programs.

  • 3.Your income falls within our guidelines.
    HealthWell assists individuals with incomes up to 400-500% 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.
  • 4.You are receiving treatment in the United States.

    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.

Apply Now

About Melanoma

Melanoma is the most serious form of skin cancer. It begins in the pigment cells (melanocytes) that produce skin color. Most melanomas can be treated successfully if they are detected at an early stage. If melanoma is not detected at an early stage, it can spread to other parts of the body and is potentially a lethal form of cancer. Source: Melanoma Foundation

Additional Resources

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