Gout Travel Fund

Status

Open

Fund Type

Copay

Maximum Award Level

$2,500

Pharmacy Card Fund

No

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

  • Aceclofenac
  • Acemetacin
  • Allopurinol
  • Amtolmetin Guacil
  • Apazone
  • Bufexamac
  • Celecoxib
  • Clonixin
  • Colchicine
  • Colcrys
  • Cortisone
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac Potassium
  • Diclofenac Sodium
  • Diflunisal
  • Dipyrone
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Febuxostat
  • Felbinac
  • Fenbufen
  • Fenofibrate
  • Fenoprofen
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Hydrocortisone
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Krystexxa
  • Lopurin
  • Lornoxicam
  • Losartan
  • Losartan Potassium
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Meclofernamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Methylprednisolone
  • Morniflumate
  • Nabumetone
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Parecoxib
  • Pegloticase
  • Piketoprofen
  • Piroxicam
  • Prednisolone
  • Prednisone
  • Probenecid
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Sodium Thiosalicylate
  • Sulindac
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolmetin
  • Transportation - Bus
  • Transportation - Car Mileage
  • Transportation - Taxi
  • Transportation - Train
  • Triamcinolone
  • Uloric
  • Zurampic
  • Zyloprim

Fund Definition

Assistance for travel related to obtaining treatment for gout.

Grant Utilization

HealthWell estimates that patients use an average of $745 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:

  • Through the Gout Travel Fund, we are able to assist with eligible transportation costs related to receiving treatment. You will be asked to provide the Foundation with your diagnosis, which must be verified by a physician, nurse practitioner, or physician assistant’s signature. Please note, the following guidelines must be met in order for the HealthWell Foundation to consider reimbursement:

    Transportation Reimbursement:
    If you or a family member/friend drive: Driving distance between your residence and drug distribution site (pharmacy or infusion center) or blood monitoring lab site must be at least 25 miles (50 miles roundtrip), based on the most direct route. Please note, car mileage will be reimbursed at the IRS Standard Business Mileage rate, and parking fees will be reimbursed with submission of receipts.

    If you use public transportation or hire a taxi: Transportation costs incurred must be at least $10.00 one way ($20.00 roundtrip), based on the most direct route. For example, if you use a taxi to get to the drug distribution site (pharmacy or infusion center) or blood monitoring lab site, the costs incurred must be at least $20.00 roundtrip

    Proof of Date of Service is required if you do not have a current Gout copay grant with HealthWell Foundation. An associated Date of Service payment must be processed if the patient has a current Gout copay grant with HealthWell Foundation.

  • To qualify for 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. 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, please call (800) 675-8416 to speak with a HealthWell representative.
  • 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.

Need A Ride?

HealthWell has partnered with Ride Health to provide transportation services to eligible grant recipients. Through this service, we hope to eliminate the need for grant recipients to pay up-front for rides to and from appointments relating to their treatment. Fees for services are deducted directly from the patient’s grant. To learn more and to determine if you are eligible to utilize this resource, contact a HealthWell representative at 800-675-8416 or call us at least 2 business days in advance of your eligible appointment to schedule this service.
 

For our Gout Travel Fund, patients may apply for replenishment within 12 months subject to availability of funds.

About Gout

Through the Gout Travel Fund, we are able to assist with eligible transportation costs related to receiving treatment. Gout is a painful and potentially disabling form of arthritis. Gout occurs when excess uric acid (a normal waste product) collects in the body, and needle‐like urate crystals deposit in the joints. This may happen because either uric acid production increases or, more often, the kidneys cannot remove uric acid from the body well enough. Source: American College of Rheumatology

Additional Educational Resources

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