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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
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  • 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, human, and bovine )
  • Architect Ecm (n/a )
  • Arthroflex (n/a )
  • Aurix (n/a )
  • Bio-Connekt Wound Matrix (n/a )
  • Biodfence (n/a )
  • Biodfence Dryflex (n/a )
  • Biovance (*amniotic membrane allograft (human) sheet 1 cm x 2 cm** )
  • Biovance (*amniotic membrane allograft (human) sheet 2 cm x 3 cm*** )
  • Biovance (*amniotic membrane allograft (human) sheet 4 cm x 4 cm*** )
  • Biovance (*amniotic membrane allograft (human) sheet 6 cm x 6 cm*** )
  • Clarixflo (n/a )
  • Cymetra Injectable (n/a )
  • Dermacell (n/a )
  • Dermagraft (cultured skin substitute, human, and bovine )
  • Dermapure (n/a )
  • Dermavest And Plurivest (n/a )
  • Epifix Amniotic Membrane (human regenerative tissue matrix )
  • Epifix Amniotic Membrane (human regenerative tissue matrix )
  • Epifix Amniotic Membrane (human regenerative tissue matrix )
  • Epifix Amniotic Membrane (human regenerative tissue matrix )
  • Epifix Amniotic Membrane (human regenerative tissue matrix )
  • 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 (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Core (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • Grafix Prime (human regenerative tissue matrix )
  • 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 100 2Cm X 2Cm (*amniotic membrane allograft (human) sheet 2 cm x 2 cm*** )
  • Neox 100 3Cmx3Cm (*amniotic membrane allograft (human) sheet 3 cm x 3 cm*** )
  • Neox 100 4Cm X 4Cm (*amniotic membrane allograft (human) sheet 4 cm x 4 cm*** )
  • Neox 100 7Cm X 7Cm (*amniotic membrane allograft (human) sheet 7 cm x 7 cm*** )
  • Neox Cord 1K 1.5Cm X 1.5Cm (*amniotic membrane allograft (human) sheet 1.5 cm x 1.5 cm** )
  • Neox Cord 1K 2.5Cm X 2.5Cm (*amniotic membrane allograft (human) sheet 2.5 cm x 2.5 cm** )
  • Neox Cord 1K 2Cmx1Cm (*amniotic membrane allograft (human) sheet 1 cm x 2 cm** )
  • Neox Cord 1K 2Cmx2Cm (*amniotic membrane allograft (human) sheet 2 cm x 2 cm*** )
  • Neox Cord 1K 3Cmx2Cm (*amniotic membrane allograft (human) sheet 2 cm x 3 cm*** )
  • Neox Cord 1K 3Cmx3Cm (*amniotic membrane allograft (human) sheet 3 cm x 3 cm*** )
  • Neox Cord 1K 4Cm X 3Cm (*amniotic membrane allograft (human) sheet 4 cm x 3 cm*** )
  • Neox Cord 1K 6Cm X 3Cm (*amniotic membrane allograft (human) sheet 6 cm x 3 cm*** )
  • Neox Cord 1K 8Cm X 3Cm (*amniotic membrane allograft (human) sheet 8 cm x 3 cm*** )
  • Nushield (n/a )
  • Oasis Burn Matrix (collagen matrix meshed (porcine) sheet 7 x 20 cm )
  • Oasis Ultra (porcine acell submucosa,meshed )
  • Oasis Ultra (porcine acell submucosa,meshed )
  • Oasis Ultra (porcine submucosa, fenestrated )
  • Oasis Ultra (porcine submucosa, fenestrated )
  • Primatrix (n/a )
  • Promogran (n/a )
  • Regranex (becaplermin )
  • Regranex (becaplermin )
  • Repriza (n/a )
  • Revitalon (n/a )
  • Skin Substitute, Nos (n/a )
  • Stravix (human regenerative tissue matrix )
  • Stravix (human regenerative tissue matrix )
  • Surgimend, Bovine Fetal (n/a )
  • Surgimend, Bovine Neonatal (n/a )
  • Talymed (n/a )
  • Tensix (n/a )
  • Theraskin (n/a )
  • Unite Biomatrix (n/a )
  • Wound Matrix (porcine submucosa, fenestrated )
  • Xcm Biologic Tiss Matrix (n/a )

Diagnosis Codes:

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