Amyotrophic Lateral Sclerosis

Status

Open

Fund Type

Copay
Premium (Medicare Part B only)

Maximum Award Level

$15,000

Pharmacy Card Fund

Yes

Minimum Copay
Reimbursement Amount

Minimum Copay Reimbursement Amount

We encourage you to please use your HealthWell pharmacy card for any applicable charges as possible.

None

Minimum Premium
Reimbursement Amount

Minimum Premium Reimbursement Amount

We encourage you to please submit monthly reimbursement claims (even if your premium is paid on a bi-weekly basis).

None

Household Income Limit

500% of the Federal Poverty Level
(adjusted for household size and high
cost of living areas)

Fund Alerts

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Treatments Covered

  • Botox
  • Cuvposa
  • Edaravone
  • Elavil
  • Exservan
  • Gabapentin
  • Glycopyrrolate
  • Increlex
  • Nuedexta
  • Qalsody
  • Radicava
  • Recombinant
  • Rilutek
  • Riluzole
  • Tiglutik

Fund Definition

Assistance with the prescription drugs and biologics used in the treatment amyotrophic lateral sclerosis.

Grant Utilization

HealthWell estimates that patients use an average of $7,300 during their 12-month grant period for this disease area.

Do I Qualify?

HealthWell bases eligibility on an individual’s medical, financial and insurance situation. To qualify for HealthWell’s assistance, applicants must meet the following eligibility requirements:

  • Please make sure that HealthWell currently has a fund for your diagnosis/indication and that your medication is covered under that fund by visiting our Disease Funds listing. If we do not have a fund that currently covers your diagnosis, please check back as we frequently open and reopen programs as funding becomes available. The Foundation is able to help patients receiving treatment for indications for which we currently have an open fund. We can only assist with medications that have been prescribed to treat the disease/covered diagnosis. You will be asked to provide the Foundation with the patient’s diagnosis, which must be verified by a physician, nurse practitioner, or physician assistant’s signature. The patient must receive treatment in the United States.

  • To qualify for copayment assistance from HealthWell, you must have some form of health insurance (private insurance, Medicare, Medicaid, TriCare, etc.) that covers part of the cost of your treatment. Please note that in order to qualify for premium assistance through this fund, you must have Medicare Part B. The Foundation will refer patients without prescription insurance to other programs, such as manufacturer patient assistance programs.

  • HealthWell assists individuals with incomes up to 300-500% of the Federal Poverty Level. The Foundation also considers the number in a household and cost of living in a particular city or state. If you believe you qualify for assistance, you may begin the application process here.

  • If you are receiving treatment in the U.S. and have met the eligibility criteria as listed, you are ready to apply! Please note that you will be asked to provide a Social Security Number in order to create a grant. This information is gathered to eliminate duplicate applications and is kept secure and confidential.

 

For our Amyotrophic Lateral Sclerosis Fund, patients may apply for replenishment within 12 months subject to availability of funds.

About Amyotrophic Lateral Sclerosis (ALS)

ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. The motor nerves affected by ALS are the motor neurons that provide voluntary movements and muscle control. Onset of the disease typically occurs in people between the ages of 40 and 70. There are two different types of ALS: sporadic and familial. Familial ALS is inherited, while sporadic ALS can affect anyone. Sporadic ALS is the most common form of ALS, accounting for 90 to 95 percent of all cases. ALS is approximately 20 percent more common in men than women. There is no cure for ALS. Source: ALS Association

Additional Educational Resources

You may also visit our Resource List to view other copayment organizations that may provide assistance.