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Inherited Retinal Disease Travel

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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 Travel fund is currently closed. As of December 12, 2018, The Assistance Fund’s Inherited Retinal Diseases fund is accepting applications.

 

Travel Assistance Programs

Assistance Amount

$10,800 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 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. Patient must be required to travel more than 20 miles (one way) to receive their prescribed treatment. Exceptions to distance requirements are made for patients living in large metropolitan cities.
  5. The patient’s income must fall at or below 500% of the Federal Poverty Level.
  6. 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: H35.50, H35.51, H35.52, H35.53, H35.54, H31.21, H35.311, H35.312, H35.313, H35.319, H35.321, H35.322, H35.323, H35.329, 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

 

Related Organizations: