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Inherited Retinal Disease Premium

Get Help with Your Treatment

Apply Online or call 1-866-316-7263


Program Status

Currently Closed – We are no longer accepting or processing applications for new or renewal patients.


The PAN Foundation’s Inherited Retinal Disease Premium fund is currently closed. As of February 13, 2019, The Assistance Fund is accepting applications.


For current information, log in to FundFinder

Assistance Amount

$2,700 per year. Patients may apply for a second grant during their eligibility period subject to availability of funding.


Premium Assistance FAQs

Eligibility Criteria

  1. The patient must be getting treatment for inherited retinal disease.
  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 500% 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  
  • Aquasol A (vitamin a palmitate)
  • Avastin (bevacizumab)
  • Bevacizumab (bevacizumab)
  • Eylea (aflibercept)
  • Lovaza (omega-3 acid ethyl esters)
  • Lucentis (ranibizumab)
  • Luxturna (voretigene neparvovec-rzyl)
  • Omega-3 Acid Ethyl Esters (omega-3 acid ethyl esters)
  • Triklo (omega-3 acid ethyl esters)

Diagnosis Codes:

ICD-10: H31.21, H35.3110, H35.3111, H35.3112, H35.3113, H35.3114, H35.3120, H35.3121, H35.3122, H35.3123, H35.3124, H35.3130, H35.3131, H35.3132, H35.3133, H35.3134, H35.3190, H35.3191, H35.3192, H35.3193, H35.3194, H35.3210, H35.3211, H35.3212, H35.3213, H35.3220, H35.3221, H35.3222, H35.3223, H35.3230, H35.3231, H35.3232, H35.3233, H35.3290, H35.3291, H35.3292, H35.3293, H35.351, H35.352, H35.353, H35.359, H35.361, H35.362, H35.363, H35.369, H35.371, H35.372, H35.373, H35.379, H35.50, H35.51, H35.52, H35.53 H35.54, H35.89, H44.20, H44.21, H44.22, H44.23, H44.2A1, H44.2A2, H44.2A3, H44.2A9, H47.21, H47.211, H47.212, H47.213, H47.219, H47.22


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