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Venous Leg Ulcers

Get Help with Your Treatment

Apply Online or call 1-866-316-7263

 

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.

 

 

Assistance Amount

$1,100  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 venous leg ulcers.
  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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  • Actiform Cool (n/a)
  • Affinity (n/a)
  • Alloderm (n/a)
  • Alloskin (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)
  • 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)
  • 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, Inj, 1Mg (n/a)
  • Excellagen (n/a)
  • Ez-Derm (n/a)
  • Flexhd/Allopatch Hd/Matrix Hd (n/a)
  • Fortaderm (Collagen Fenestrated (Porcine) Sheet)
  • Gammagraft (n/a)
  • Grafix Core (human regenerative tissue matrix)
  • Grafix Prime (human regenerative tissue matrix)
  • Graftjacket (n/a)
  • Granuflex (umbilical cord allograft)
  • Helicoll (n/a)
  • Hyalomatrix (n/a)
  • Integra Bmwd (n/a)
  • Integra Flowable Wound Matrix (n/a)
  • Integra Meshed Bil Wound Mat (n/a)
  • Iodosorb (cadexomer iodine)
  • Keramatrix, Per Sq. Cm (n/a)
  • Matristem Burn Matrix (n/a)
  • Matristem Micromatrix (n/a)
  • Nugel (n/a)
  • Oasis Burn Matrix (Collagen Matrix Meshed (Porcine) Sheet 7 X 20 CM)
  • Oasis Ultra (porcine acell submucosa, meshed)
  • Primatrix (n/a)
  • Promogran (n/a)
  • PuraPly (n/a)
  • Purilon Gel (n/a)
  • Sandostatin (octreotide acetate)
  • Santyl (collagenase clostridium histolyticum)
  • Talymed (n/a)
  • Theraskin (n/a)
  • Total Parenteral Nutrition Formulation (n/a)
  • Unite Biomatrix (n/a)
  • Wound Matrix (porcine submucosa, fenestrated)

Diagnosis Codes:

ICD-10: I83.001, I83.002, I83.003, I83.004, I83.005, I83.008, I83.009, I83.011, I83.012, I83.013, I83.014, I83.015, I83.018, I83.019, I83.021, I83.022, I83.023, I83.024, I83.025, I83.028, I83.029, I83.201, I83.202, I83.203, I83.204, I83.205, I83.208, I83.209, I83.211, I83.212, I83.213, I83.214, I83.215, I83.218, I83.219, I83.221, I83.222, I83.223, I83.224, I83.225, I83.228, I83.229, I87.011, I87.012, I87.013, I87.019, I87.031, I87.032, I87.033, I87.039, I87.311, I87.312, I87.313, I87.319, I87.331, I87.332, I87.333, I87.339