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Immune Thrombocytopenic Purpura Travel

Get Help with Your Treatment

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Program Status

Open - We are accepting applications for new and renewal patients. If your application for assistance is approved you can begin receiving funding immediately.

Maximum Award Level

$1,300 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’s medication or product must be listed on PAN’s list of covered medications.
  3. Patient must be required to travel greater than 20 miles (one way) to receive their prescribed treatment. Exceptions to distance requirements are made for patients living in large metropolitan cities.
  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.)

Travel Assistance Program Details

PAN offers travel assistance for patients seeking treatment for Idiopathic Thrombocytopenic Purpura. Our Travel Assistance will cover approved mileage and parking reimbursement and will provide patients with a high-touch service model that assists in the scheduling of their travel needs.

Transportation

  • » The fund will cover mileage and parking to medical appointments related to approved therapy as determined by the prescribing physician.
  • » An appointment with the healthcare provider must be scheduled prior to arranging transportation.
  • » Patients must be approved for travel assistance at least two business days in advance of the appointment to ensure travel means are available.
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See the list of medications covered in this program
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  • Active Injection Kit D (dexamethasone sodium phosphate/pf)
  • A-Hydrocort (hydrocortisone sod succinate)
  • Bivigam (immune globulin,gamm(igg)/glycine/iga greater than 50 mcg/ml)
  • Carimune Nf Nanofiltered (immune globulin,gamm(igg)/sucrose/iga greater than 50 mcg/ml)
  • Cortef (hydrocortisone)
  • Cortisone Acetate (cortisone acetate)
  • Deltasone (prednisone)
  • Dexamethasone (dexamethasone)
  • Dexamethasone Intensol (dexamethasone)
  • Dexamethasone Sodium Phosphate (dexamethasone sod phosphate)
  • Dexamethasone Sodium Phosphate (dexamethasone sodium phosphate/pf)
  • Dexpak (dexamethasone)
  • Doubledex (dexamethasone sodium phosphate/pf)
  • Flebogamma Dif (immune globulin,gamma (igg)/sorbitol/iga 0 to 50 mcg/ml)
  • Flo-Pred (prednisolone acetate)
  • Gamastan S-D (immune globulin,gamma(igg)/glycine)
  • Gammagard Liquid (immune globulin,gamm(igg)/glycine/iga greater than 50 mcg/ml)
  • Gammagard S-D (immune globulin,gamm(igg)/glycine/glucose/iga 0 to 50 mcg/ml)
  • Gammaked (immune globulin,gamma(igg)/glycine/iga average 46 mcg/ml)
  • Gammaplex (immune globulin,gamm(igg)/sorbitol/glycin/iga 0 to 50 mcg/ml)
  • Gamunex-C (immune globulin,gamma(igg)/glycine/iga average 46 mcg/ml)
  • Hydrocortisone (hydrocortisone)
  • Medrol (methylprednisolone)
  • Methylprednisolone (methylprednisolone)
  • Methylprednisolone Sodium Succ (methylprednisolone sodium succinate)
  • Millipred (prednisolone)
  • Millipred (prednisolone sod phosphate)
  • Millipred Dp (prednisolone)
  • Nplate (romiplostim)
  • Octagam (immune globulin,gamm(igg)/maltose/iga greater than 50 mcg/ml)
  • Orapred (prednisolone sod phosphate)
  • Orapred Odt (prednisolone sod phosphate)
  • Pediapred (prednisolone sod phosphate)
  • Prednisolone (prednisolone)
  • Prednisolone Sodium Phos Odt (prednisolone sod phosphate)
  • Prednisolone Sodium Phosphate (prednisolone sod phosphate)
  • Prednisone (prednisone)
  • Prednisone Intensol (prednisone)
  • Prelone (prednisolone)
  • Privigen (immune globulin,gamma (igg)/proline/iga 0 to 50 mcg/ml)
  • Promacta (eltrombopag olamine)
  • Rayos (prednisone)
  • Rhophylac (rho(d) immune globulin)
  • Rituxan (rituximab)
  • Solu-Cortef (hydrocortisone sod succinate)
  • Solu-Cortef (hydrocortisone sodium succinate/pf)
  • Solu-Medrol (methylprednisolone sodium succinate)
  • Solu-Medrol (methylprednisolone sodium succinate/pf)
  • Veripred 20 (prednisolone sod phosphate)
  • Winrho Sdf (rho(d) immune globulin/maltose)

Diagnosis Codes:

ICD-10: D69.3