ATTENTION: HealthWell Foundation headquarters and hotline will be closing on Friday, April 19, 2019 at 3:00 p.m. in observance of the holiday weekend. Our office and hotline will re-open on Monday, April 22, 2019 at 9:00 a.m. We encourage you to continue to use our Patient, Pharmacy and Provider Portals during this time.  Please note: if you are contacting us about a payment or grant, it is faster to email us at grants@healthwellfoundation.org.  The HealthWell Team wishes you and yours a happy, safe and healthy holiday.

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Nontuberculous Mycobacterium - Medicare Access (Medicare patients only)

Status

Open

Fund Type

Copay/Premium

Maximum Award Level

$2,000

Pharmacy Card Fund

Yes

Household Income Limit

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

Treatments Covered

  • Arikayce
  • Avelox
  • Cetraxal
  • Cipro
  • Clarithromycin
  • Clofazimine
  • Coly-mycin M
  • Cycloserine
  • Doxycycline
  • Erythromycin
  • Floxin
  • Isoniazid
  • Myambutol
  • Mycobutin
  • Ocuflox
  • Priftin
  • Rifadin
  • Sirturo
  • Streptomycin
  • Tygacil
  • Vigamox
  • Zithromax
  • Zymaxid

Fund Definition

Assistance with the prescription drugs and biologics used in the treatment of nontuberculous mycobacteria.

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 Nontuberculous Mycobacterium.

    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 Fund 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 Nontuberculous Mycobacterium (NTM)

Nontuberculous mycobacterium (NTM) are naturally-occurring organisms (germs) found in water and soil. While most species of NTM do not cause human disease, except in people with weak lungs or immune systems, people who are susceptible inhale the organisms from misty water or from the soil, which lead to lung infections, according to the Chest Foundation. These lung infections become slowly progressive, which can destroy lung tissue and lead to other, more serious lung conditions. Between 12 and 18 thousand new cases of NTM lung infections are diagnosed each year in the United States. Source: Chest Foundation

 

Additional Resources

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