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How to File a Claim

 

 

There are three ways you can submit an expense to PAN for reimbursement:

  1. If you receive your medication from your pharmacy, your pharmacist can send the bill to PAN.
  2. If your physician gives you your medication in the office, your physician can send the bill to PAN after submitting it to your insurance company.
  3. If your pharmacy or physician does not submit the bill to PAN, you can pay for the medication or service yourself and download a Proof of Expenditure form below to send to PAN.
 

Proof of Expenditure Form: Medications and Treatments

PAN grant recipients can submit PAN-approved expenses for reimbursement using the Proof of Expenditure form. You do not need to complete this form if your healthcare provider or pharmacist has submitted or will submit a claim on your behalf.

 

Download Form

 

Proof of Expenditure Form: Premium and Travel

PAN grant recipients can submit PAN-approved expenses for reimbursement using the Proof of Expenditure Premium and Travel form.

 

Download Form

 

Frequently Asked Questions

For a full list of frequently asked questions about claims processing, click on the link below.

 

Learn More