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Uveitis

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Program Status

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

 

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Assistance Amount

$900 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 uveitis.
  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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  • A-hydrocort (hydrocortisone sod succinate)
  • Atropine Sulfate (atropine sulfate)
  • Azathioprine (azathioprine)
  • Betamethasone Acetate-sod Phos (betamethasone acetate and sodium phos in sterile water/pf)
  • Betamethasone Sod Phos-acetate (betamethasone acetate/betamethasone sodium phosphate)
  • Blephamide S.o.p. (sulfacetamide sodium/prednisolone acetate)
  • Celestone (betamethasone acetate/betamethasone sodium phosphate)
  • Cellcept (mycophenolate mofetil)
  • Cortef (hydrocortisone)
  • Cortisone Acetate (cortisone acetate)
  • Cortisporin (neomycin/bacitracin/polymyxin b/hydrocortisone)
  • Cyclogyl (cyclopentolate hcl)
  • Cyclopentolate Hcl (cyclopentolate hcl)
  • Cyclosporine (cyclosporine)
  • Deltasone (prednisone)
  • Depo-medrol (methylprednisolone acetate)
  • Durezol (difluprednate)
  • Enbrel (etanercept)
  • Flarex (fluorometholone acetate)
  • Fluorometholone (fluorometholone)
  • Fml Forte (fluorometholone)
  • Fml S.o.p. (fluorometholone)
  • Homatropaire (homatropine hbr)
  • Homatropine Hydrobromide (homatropine hbr)
  • Humira Pen Psor-uveits-adol Hs (adalimumab)
  • Humira(cf) (adalimumab)
  • Humira(cf) Pediatric Crohn's (adalimumab)
  • Humira(cf) Pen Crohn's-uc-hs (adalimumab)
  • Hydrocortisone (hydrocortisone)
  • Inflectra (infliximab-dyyb)
  • Isopto Atropine (atropine sulfate)
  • Leukeran (chlorambucil)
  • Maxitrol (neomycin/polymyxin b sulfate/dexamethasone)
  • Medrol (methylprednisolone)
  • Methotrexate (methotrexate sodium)
  • Methylprednisolone (methylprednisolone)
  • Methylprednisolone Acetate (methylprednisolone acetate)
  • Methylprednisolone Sodium Succ (methylprednisolone sodium succinate)
  • Millipred (prednisolone)
  • Millipred (prednisolone sodium phosphate)
  • Mycophenolate Mofetil (mycophenolate mofetil)
  • Neomycin-bacitracin-poly-hc (neomycin sulfate/bacitracin zinc/polymyxin b/hydrocortisone)
  • Neomycin-polymyxin-dexameth (neomycin/polymyxin b sulfate/dexamethasone)
  • Neomycin-polymyxin-hc (neomycin sulfate/polymyxin b sulfate/hydrocortisone)
  • Neo-polycin Hc (neomycin sulfate/bacitracin zinc/polymyxin b/hydrocortisone)
  • Omnipred (prednisolone acetate)
  • Orapred Odt (prednisolone sodium phosphate)
  • Ozurdex (dexamethasone)
  • Pediapred (prednisolone sodium phosphate)
  • Pred Forte (prednisolone acetate)
  • Pred Mild (prednisolone acetate)
  • Pred-g (gentamicin sulfate/prednisolone acetate)
  • Prednisolone (prednisolone)
  • Prednisolone Acetate (prednisolone acetate)
  • Prednisolone Sodium Phosphate (prednisolone sodium phosphate)
  • Prednisone (prednisone)
  • Rayos (prednisone)
  • Remicade (infliximab)
  • Renflexis (infliximab-abda)
  • Restasis (cyclosporine)
  • Restasis Multidose (cyclosporine)
  • Retisert (fluocinolone acetonide)
  • Sirolimus (sirolimus)
  • Solu-cortef (hydrocortisone sodium succinate/pf)
  • Sulfacetamide-prednisolone (sulfacetamide sodium/prednisolone sodium phosphate)
  • Tacrolimus (tacrolimus)
  • Tobradex (tobramycin/dexamethasone)
  • Tobramycin-dexamethasone (tobramycin/dexamethasone)
  • Triamcinolone Acetonide (triamcinolone acetonide)
  • Triamcinolone Diacetate (triamcinolone diacetate in 0.9 % sodium chloride)
  • Triesence (triamcinolone acetonide/pf)
  • Veripred 20 (prednisolone sodium phosphate)
  • Yutiq (fluocinolone acetonide)
  • Zylet (tobramycin/loteprednol etabonate)

Diagnosis Codes:

ICD-10: D86.83, H20.00, H20.011, H20.012, H20.013, H20.019, H20.021, H20.022, H20.023, H20.029, H20.031, H20.032, H20.033, H20.039, H20.041, H20.042, H20.043, H20.049, H20.051, H20.052, H20.053, H20.059, H20.10, H20.11, H20.12, H20.13, H20.20, H20.21, H20.22, H20.23, H20.811, H20.812, H20.813, H20.819, H20.821, H20.822, H20.823, H20.829, H20.9 H30.001, H30.002, H30.003, H30.009, H30.011, H30.012, H30.013, H30.019, H30.021, H30.022, H30.023, H30.029, H30.031, H30.032, H30.033, H30.039, H30.041, H30.042, H30.043, H30.049, H30.101, H30.102, H30.103, H30.109, H30.111, H30.112, H30.113, H30.119, H30.121, H30.122, H30.123, H30.129, H30.131, H30.132, H30.133, H30.139, H30.141, H30.142, H30.143, H30.149, H30.20, H30.21, H30.22, H30.23, H30.811, H30.812, H30.813, H30.819, H30.891, H30.892, H30.893, H30.899, H30.90, H30.91, H30.92, H30.93, H44.111, H44.112, H44.113, H44.119, H44.131, H44.132, H44.133, H44.139

 

About the Disease:

Uveitis is a retinal disorder that affects the middle layer of tissue in the eye wall. It is a rare disease of the nervous system.

 

Source: National Institutes of Health