Attention: The HealthWell Foundation has changed its P.O. Box! Our new address is: P.O. Box 489, Buckeystown, MD 21717. Please update your records now to avoid future delays in processing.
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.
Dismiss alert

Peyronie's Disease

Status

Open

Fund Type

Copay/Premium

Maximum Award Level

$5,600

Pharmacy Card Fund

Yes

Household Income Limit

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

Treatments Covered

  • Colchicine
  • Colcrys
  • Collagenase
  • Dmso
  • Injection
  • Injection Procedure
  • Interferon
  • Pentoxifylline
  • Potaba
  • Propoleum
  • Routine Venipuncture
  • Sildenafil Citrate
  • Tamoxifen Citrate
  • Urinalysis
  • Verapamil
  • Xiaflex

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 Peyronie's Disease.

    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 insurance and it covers your medication.

    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.

  • 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 Peyronie’s Disease

Peyronie’s (pa-ro-NEEZ) disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections. In some men, Peyronie’s disease causes a significant bend or pain, which can prevent a man from having sex or may make it difficult to get or maintain an erection (erectile dysfunction). Source: Mayo Clinic

Additional Resources

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