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Diabetic Foot Ulcers

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Apply Online or call 1-866-316-7263

 

Program Status

Fully Allocated – We are no longer accepting or processing applications for new or renewal patients.

 

 

Maximum Award Level

$3,500 per year. Patients may apply for a second grant during their eligibility period subject to availability of funding.

Eligibility Criteria

  1. The patient must be getting treatment for the disease named in the assistance program to which he or she is applying.
  2. The patient must have health insurance that covers his or her qualifying medication or product. 
  3. The patient’s medication or product must be listed on PAN’s list of covered medications.
  4. The patient’s income must fall at or below 400% of the Federal Poverty Level.
  5. The patient must reside and receive treatment in the United States or U.S. territories. (U.S. citizenship is not a requirement.)
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See the list of medications covered in this program
View List  
  • Affinity (N/A)
  • Alloderm (N/A)
  • Alloskin (N/A)
  • Alloskin AC, 1cm (N/A)
  • Alloskin Rt (N/A)
  • Allowrap DS Or Dry (N/A)
  • Amnioband, Guardian (N/A)
  • Amnioexcel / Bio D Excel (N/A)
  • Amniomatrix / Biodmatrix (N/A)
  • Amniopro Flow, Bioskin Flow, Biorenew Flow, Wound Ex Flow, Amniogen-A Amniogen-C (N/A)
  • Amniopro, Bioskin, Biorenew, Woundex, Amniogen-45, Amniogen-200 (N/A)
  • Apligraf (Cultured Skin Substitute - Disk)
  • Architect ECM (N/A)
  • Arthroflex (N/A)
  • Bio-Connekt Wound Matrix (N/A)
  • Biodfence (N/A)
  • Biodfence Dryflex (N/A)
  • Biovance (Amniotic Membrane Allograft (Human) Sheet)
  • Clarixflo (N/A)
  • Cymetra Injectable (N/A)
  • Dermacell (N/A)
  • Dermagraft (Cultured Skin Substitute - Sheet)
  • Dermapure (N/A)
  • Dermavest And Plurivest (N/A)
  • Epifix (Amniotic Membrane Allograft (Human) Sheet)
  • Epifix, Inj, 1mg (N/A)
  • Excellagen (N/A)
  • EZ-Derm (N/A)
  • FlexHD/Allopatch HD/Matrix HD (N/A)
  • Fortaderm (Collagen Fenestrated (Porcine) Sheet)
  • Fortaderm Antimicrobial Phmb (Collagen-Antimicrobial Sheet)
  • Gammagraft (N/A)
  • Grafix Core (Multipotent Cellular Repair Matrix - Misc)
  • Grafix Prime (Multipotent Cellular Repair Matrix - Misc)
  • Graftjacket (N/A)
  • Graftjacket Xpress (N/A)
  • Helicoll (N/A)
  • Hmatrix (N/A)
  • Hyalomatrix (N/A)
  • Integra Bmwd (N/A)
  • Integra DRT (N/A)
  • Integra Flowable Wound Matrix (N/A)
  • Integra Matrix (N/A)
  • Integra Meshed Bil Wound Mat (N/A)
  • Keramatrix, Per Sq. Cm (N/A)
  • Marigen (N/A)
  • Matristem Burn Matrix (N/A)
  • Matristem Micromatrix (N/A)
  • Matristem Wound Matrix (N/A)
  • Mediskin (N/A)
  • Memoderm/Derma/Tranz/Integup (N/A)
  • Neox (Amniotic Membrane Allograft (Human) Sheet)
  • Neox Cord (Amniotic Membrane Allograft (Human) Sheet)
  • Nushield (N/A)
  • Oasis Burn Matrix (Collagen Matrix Meshed (Porcine) Sheet)
  • Oasis Ultra Tri-Layer Matrix (Collagen Matrix Meshed (Porcine) Sheet)
  • Oasis Ultra Tri-Layer Matrix Fenestrated (Collagen Matrix Fenestrated (Porcine) Sheet)
  • Oasis Ultra Tri-Layer Matrix Meshed (Collagen Matrix Meshed (Porcine) Sheet)
  • Oasis Wound Matrix (Collagen Matrix Meshed (Porcine) Sheet)
  • Oasis Wound Matrix (Collagen Matrix Fenestrated (Porcine) Sheet)
  • Primatrix (N/A)
  • Promogran (N/A)
  • Regranex (Becaplermin Gel 0.01%)
  • Repriza (N/A)
  • Revitalon (N/A)
  • Skin Substitute, Nos (N/A)
  • Stravix (Amniotic Membrane Allograft (Human) Sheet)
  • Surgimend, Bovine Fetal (N/A)
  • Surgimend, Bovine Neonatal (N/A)
  • Talymed (N/A)
  • Tensix (N/A)
  • Theraskin (N/A)
  • Unite Biomatrix (N/A)
  • XCM Biologic Tiss Matrix (N/A)

Diagnosis Codes:

ICD-10: E08.621, E09.621, E10.621, E11.621, E13.621