RECORDATORIO: Nuestro equipo de la línea de atención telefónica está trabajando a distancia y centrando su tiempo en ayudar a nuestros pacientes. Agradecemos a las farmacias, a los proveedores y a su personal que utilicen nuestros Portales de Farmacia y de Proveedores. Por favor, tenga en cuenta que si se pone en contacto con nosotros sobre un pago o una subvención, es más rápido enviarnos un correo electrónico a [email protected]. Le agradecemos su paciencia y esperamos seguir sirviéndole. Les deseamos a todos seguridad y buena salud durante estos momentos difíciles. El equipo de HealthWell
Pediatric Assistance
Status
Do-not-Display (Accepting phone applications only)Fund Type
CopayMaximum Award Level
Pharmacy Card Fund
NoMinimum CopayReimbursement Amount
We encourage you to please use your HealthWell pharmacy card for any applicable charges as possible.
Minimum Premium
Reimbursement Amount
Household Income Limit
500% of the Federal Poverty Level(adjusted for household size and high
cost of living areas)
Treatments Covered
- 5-hydroxytryptophan
- Abilify
- Absorbent Gel
- Accu-chek Guide Meter
- Accu-chek Lancets
- Accu-chek Test Strips
- Acetaminophen
- Actemra
- Actigall
- Acupuncture Therapy
- Acyclovir
- Adaptive Behavior Treatment
- Adderall Xr
- Adhesive Removal
- Adint Therapy
- Admelog Insulin
- Administrative Fees
- Adrenevive
- Advanced Headrest & Bumper Pack
- Advocacy Services
- Aent B Kit
- Aent Pump Set
- Afinitor
- Airex Foam Mat
- Alcohol Prep Swabs
- Alginate Dressing
- Alkindi Sprinkle
- Allegra
- Allergy Immunotherapy
- Allopurinol
- Altera Neb System
- Alvesco
- Ambulance Service
- Aminocaproic Acid
- Ammonium
- Amnesteem
- Amox-clav
- Amoxicillin
- Amtryke
- Anamix
- Anbesol
- Androgel
- Anesthesia
- Angel Sense Monitoring Service
- Animas Cartridge
- Animas Inset Pump
- Antineoplastons
- Apidra
- Aptensio Xr
- Apump Enteral Ambulator
- Aquaflush Lite Irrigation System
- Aquatherapy
- Arginine
- Arnuity
- Asparlas
- Atenolol
- Audio Hearing Therapy
- Audio Therapy Assistance
- Audiology
- Audiometry Testing
- Autism Assist Products
- Autosoft Infusion Set
- Auvi-q
- Avastin
- Azathioprine
- Azelastine
- Azulfidine
- Bacitracin Ointment.
- Back Brace
- Bactrim
- Balsalazide
- Banophen
- Baqsimi
- Basaglar
- Bd Glucose Tab
- Bd Pen Needle
- Bd Sharps Container
- Bd Syrup
- Betapace
- Biktarvy
- Biocidin Broad Spectrum Liquid
- Biohpf
- Biotene
- Bipap Machine
- Bisacodyl
- Blincyto
- Bone Age Study
- Botox
- Bottle Amber Glass
- Botulinum Toxin Injection (btx)
- Brainchild Spectrum Support Vitamins
- Breathsmart Air Purifier System
- Briumvi
- Briviact
- Bumetanide
- Bupropion
- Buspirone
- Buzzy Distraction Cards
- Buzzy Xl
- C-ivermectin
- C-magnesium
- Calcitriol
- Calcium
- Camp Therapy
- Cannula Infusion Set
- Cannula Tubing
- Car Seat (adaptable) Due To Dx
- Carbaglu
- Cardiovascular Service
- Carnitine
- Carnitor
- Casodex
- Cast Application
- Catapres
- Catheter Procedure
- Cefdinir
- Cefepime Hydrochloride
- Ceftriaxone
- Celebrex
- Cellcept
- Central Line Wrap
- Cephalexin
- Cetirizine
- Cetraxal
- Cgm Analysis
- Cgm Glucose Sensor
- Cgm Transmitter
- Chemotherapy Administration
- Cherry Syrup
- Children Aspirin
- Chin & Neck Strap
- Chiropractic Adjustment
- Chlorhexidine Gluconate Solution
- Choiceful Vitamins
- Cipro
- Ciprodex
- Claravis
- Claritin
- Classroom Aid Due To Dx
- Clindamycin
- Clonazepam
- Clonidine
- Cmt Spi 1-2 Regions
- Coag-sense Inr
- Coag-sense Lancets
- Coag-sense Monitor
- Coag-sense Test Strips
- Colchicine
- Combivent
- Compliance History
- Compression Socks
- Computerized Tomography (ct) Scan
- Concerta
- Contour Strips
- Coq10
- Corgard
- Corlanor
- Cosentyx (secukinumab)
- Cosopt
- Cotempla Xr-odt
- Counseling Services
- Cpap Mask/supplies
- Cranial Prosthesis
- Cranial Sacral Adjustment
- Cresemba
- Cromolyn
- Curcumin Turmeric
- Custom Orthotics
- Cyclophosphamide
- Cyclosporine
- Cymbalta
- Cyproheptadine
- Cystadane
- Cystagon
- Cytarabine
- Cytozyme Ad
- D-amphetamine
- Dapsone
- Daytrana
- Ddavp
- Dekas Plus
- Delica Lancing Device
- Delivery Charges
- Deltasone
- Dental Treatment-diagnosis
- Dermoplast
- Desitin
- Desonide Cream
- Destruct Lesion
- Developmental Screening
- Developmental Therapy
- Dexamethasone
- Dexcom G6
- Dexcom Receiver
- Dexcom Sensor Kit
- Dexcom Transmitter Kit
- Dexmethylphenidate
- Diabetic Insulin
- Diabetic Lancets
- Diabetic Monitor
- Diabetic Monitor Phone
- Diabetic Syringes
- Diabetic Test Strips
- Dialysis Supply
- Diastat Acudial
- Diflucan
- Digoxin
- Dihydroepiandrosterone (dhea)
- Dilantin
- Distraction Cards
- Ditropan/oxybutynin
- Diuril
- Divalproex
- Dme Cranial Remolding Helmet
- Dme Rentals
- Dojolvi
- Doptelet
- Doxycycline Hyclate
- Droxidopa
- Dupixent
- Durable Medical Equip Rental
- Ebrace Empatica Service
- Echocardiogram
- Eeg Mapping
- Elecare Jr Powder-vanilla
- Electrocardiogram
- Electromyelogram
- Electrophysiologic Evaluation
- Elemental Diet Powder
- Emend
- Emergency Flight
- Emergency Room Care
- Endari
- Enlite Glucose Monitor Sensor
- Ensure Nutritional
- Enteral Nutrition
- Enteralite Pump
- Entresto
- Entyvio
- Epaned
- Epidoilex
- Epipen
- Epivir
- Epoetin
- Epogen
- Epzicom
- Equip Rental/supplies
- Erlotinib
- Eros Pod 10pk
- Eryped
- Erythromycin
- Escitalopram
- Esophagogastroduodenoscopy
- Estradiol
- Ethyl Chloride Spray
- Etoposide
- Eucrisa
- Evan Calcaneal Osteotomy
- Eye Glasses Due To Illness
- Famotidine
- Fast Vacuolar Magnesium (fv)
- Feeding Therapy
- Ferrous Sulfate
- Fiasp Flextouch Pen
- Fintepla
- Flex Space Table
- Flexitouch System
- Flovent
- Fludrocortisone
- Fluocinolone Acetonide
- Fluocinonide
- Fluoxetine
- Fluvoxamine
- Foam Dressing
- Focalin
- Folic Acid
- Foot Orthotics
- Freestyle Libre Reader
- Freestyle Monitor
- Freestyle Sensor
- Freestyle Test Strips
- Fungal Culture
- Fycompa
- Gabapentin
- Gammacore Sapphire
- Gammagard
- Gammurex
- Gastrocnemius Recession
- Gastrostomy Tube Supplies
- Gattex
- Gavilax
- Gelmix
- Genesight
- Genetic Disease Testing
- Genetic Testing
- Gengraf
- Gentak
- Genvoya
- Gleevec
- Glucagon Emergency Kit
- Glucose Monitoring System
- Glucose Sensor Tape
- Glutathione
- Glutathione Nasal Vials
- Glyburide
- Glycopyrrolate
- Gnp Gas Relief
- Granisetron Exteded Release Injection
- Granix Syringes
- Gvoke Hypopen
- Handicap Van Service
- Healing Dives Chamber
- Hearing Aid
- Hearing Loss Checkup
- Hearing Tube Removal
- Heart Monitor Device
- Heartstart Onsite Aed
- Hecoria
- Heparin
- Hizentra
- Home Health Nurse
- Home Infusion Therapy
- Humalog
- Humapen Luxura Pen
- Humate P
- Humatrope
- Humira
- Humulin
- Humulin R Injection
- Hydrochlorothiazide
- Hydrocortisone
- Hydroquinone
- Hydroxocobalamin
- Hydroxychloroquine
- Hydroxyurea
- Hydroxyzine Hcl
- Hygiene Oral Product
- Hyoscyamine
- Hyperbaric Oxygen Therapy
- I-stat Cartridge
- I-stat Pca Service
- Ibuprofen
- Ige Food Panel
- Ilaris
- Ils Pillow Therapy
- Im Shot
- Impacted Cerumen
- Imuran
- Incontinence Supply
- Increlex
- Indomethacin
- Infliximab-qbtx
- Inpatient Care/surgery
- Insulin Pump
- Interdental Fixation Device
- Intuniv
- Invega
- Iontophoresis Machine
- Ipratropium Bromide
- Ivig Infusion
- Jadenu
- Jakafi
- Jantoven
- Januvia
- Jardiance
- Jornay
- K-pax Pro
- Kaletra
- Kate Farms Core Essentials
- Katerzia
- Keppra
- Ketamine
- Ketoconazole Products
- Ketofifen
- Ketostix Strips
- Klor-con
- Kro Pen Needle
- L-arginine
- L-methylfolate
- Lab Tests/cultures
- Labetalol
- Lacrilube
- Lactoferrin
- Lactulose
- Lamictal
- Lantus
- Laser Tx, Skin
- Lasix
- Lauricidin Monolaurin
- Learning Therapy
- Lens Coating
- Leucovar
- Leucovorin
- Leukine
- Levemir Flextouch
- Levocetirizine Dihydrochloride
- Levofloxacin
- Lexapro
- Lidocaine/prilocaine Cream
- Liposomal Curcumin Resveratrol
- Lisinopril
- Lispro Insulin
- Loperamide
- Loratadine
- Lorazepam
- Losartan
- Lovenox
- Low Vision Equipment
- Lubricant Eye Oint
- Luteinizing Hormone
- Lyrica
- M-dryl
- Maalox.
- Macrobid
- Magic Mouthwash
- Magnesium
- Magnetic Resonance Imaging (mri) Scan
- Magonate
- Manganese
- Mapap
- Mcr Enteral Pump Supply
- Med/surg Supplies
- Medical And Surgical (dme)
- Medical Transport
- Medtronic Battery Cap/pk
- Medtronic Guardian Sensor
- Medtronic Infusion Pk
- Medtronic Minimed Paradigm Reservoir
- Medtronic Paradigm 3.0 Reservoir
- Medtronic Tape Iv 3000
- Megace
- Melatonin
- Meloxicam
- Meropenem
- Metabolic Panel Lab Test
- Metadate Cd
- Metformin
- Methadone
- Methotrexate
- Methylcobalamin
- Methylphenidate
- Methylprednisolone
- Metox Drops
- Mg Plus Protein
- Miacalcin
- Mic-key Feeding Tube
- Microlet Lancets
- Midazolam
- Minocycline
- Mirtazapine
- Mobility Walker
- Modafinil
- Mometasone
- Monoject Syringes
- Mounjaro
- Mucinex
- Mupirocin
- Music Therapy
- Mycotoxin Panel Testing
- Mydaysis
- Myloxicam
- Myorisan
- Myrbetriq
- N-acetylcysteine Gel
- Naltrexone
- Namenda
- Naproxone
- Narcan
- Nasal Appliance/supplies
- Natures Truth Product
- Navina Classic System
- Nebulizer Therapy
- Neo Poly Dex Ophthalmic
- Neocate
- Nephronex
- Neulasta
- Neurofeedback Session
- Neurological Assessment
- Neurologist Office Copays
- Nexavar
- Nexium
- Norethindrone Acetate
- Novofine/ultrafine Needles
- Novolin Monitor
- Novolog Flexpen
- Novolog Insulin
- Novopen Echo Device
- Nuadapt
- Nutrition Assessment
- Nutrition Therapy
- Nystatin
- Occupational Therapy
- Octagam
- Office/clinic Copays
- Ofloxacin
- Olumiant
- Omeprazole
- Omnicef
- Omnipod
- Omnitrope
- One Touch Lancets
- One Touch Prep Pads
- One Touch Test Strips
- One Touch Verio
- Onfi
- Ophthalmology Visit
- Opsumit
- Optichamber Inhaler
- Opzelura
- Orencia
- Orfadin
- Oropharyngeal Treatment
- Orthopedic Therapy
- Orthotic Supplies
- Osteopathic Adjustment
- Ostomy Bodywash
- Ostomy Deodorant
- Ostomy Hair Product
- Ostomy Pouch (drain)
- Ostomy Supplies
- Ostomy Syringes
- Otezla
- Outpatient Care/surgery
- Oxcarbazepine
- Oximeter Device
- Oxitriptan
- Oxybutynin
- Oxycodone
- Oxygen Concentrator
- Ozempic
- Pacemaker Testing
- Pain Management
- Pamidronate Iv Therapy
- Pantoprazole
- Patano/olopatadinel
- Pediapred
- Pediasure
- Pegasys
- Penicillin
- Pentam
- Pentasa
- Phenergan
- Phillips Heartsart Monitor And Supplies
- Phos-nak
- Photochemotherapy W/uv-b
- Physical Therapy
- Physician Services
- Phytonadione
- Polyethylene Glycol
- Polymyxin B Trimetho
- Pomalyst
- Portable Gaseous System
- Pps Neurosurgery
- Precision Strips
- Prednisolone
- Prednisone
- Prevacid
- Prevymis
- Primal Defense Ultra
- Primsol
- Privigen
- Proair
- Probenecid
- Probiotics
- Procrit
- Proglycem
- Proomega
- Propranolol
- Prosthetics
- Provigil
- Psoas Ball
- Psp Vitamin
- Psychotherapy
- Pull-ups/diapers
- Pulmicort
- Pulmosal
- Pulmozyme
- Pulse Oximeter
- Purinethol
- Purixan
- Qelbree
- Quillichew Er
- Quillivant
- Qvar
- Radiology Tests
- Rapamune
- Rcf Formula
- Reglan
- Remicade
- Respite Home Care
- Retrovir
- Reusable Mattress Pads
- Reusable Wipes
- Rexulti
- Ribavirin
- Rifampin
- Risperdal
- Ritalin
- Ritonavir
- Rituximab
- Rizatriptan
- Roger Focus Mic System
- Rsc Brace
- Rufinamide
- Sabril
- Sami Seizure Alert
- Sandostatin Lar
- Santyloon
- Saxenda
- Scoliosis Body Sock
- Scoliosis Recumbent Bike
- Scoliosis Traction Chair
- Semglee Pen
- Senna Laxative
- Sensory Gym
- Septra
- Seroquel
- Sertraline
- Service Fee
- Sildenafil Citrate
- Similac
- Simponi
- Simvastatin
- Sirolimus
- Sirturo
- Skin Barrier Ointment
- Skin Barrier Spray
- Skin Barrier Strips
- Skin Barrier Wipes
- Sm Stool Softener
- Sodium Bicarbonate
- Sodium Chloride
- Sodium Citrate-acid Solution
- Sodium Phenylbutyrate
- Sodium Phosphate
- Solo Cortef
- Sony Amp
- Special Dietary Purchase
- Speech Device
- Speech Therapy
- Spinraza
- Spiriva Respimat
- Spironolactone
- Sporanox
- Sprycel
- Stelara
- Sterile Water
- Stivarga
- Storage Fee For Blood
- Strattera
- Sucralfate
- Support Assistance
- Suprax
- Sure Comfort Pen Needle
- Synjardy
- Synthroid
- Syntonic Phototherapy
- Syprine
- Systemic Drainage Drops
- Tabloid
- Tacrolimus
- Tambocor
- Tamiflu
- Techlite Pen Needle
- Tegaderm Dressing
- Telea Pads
- Temodar
- Tens Treatment
- Testosterone
- Tetrabenazine
- Therabite
- Therapeutic Riding Therapy
- Therapy Equipment
- Therapy Vest System
- Thyroxine
- Tobramycin
- Tonsillectomy Procedure
- Topiramate
- Tpn Intravenous Nutrition
- Transcranial Magnetic Stimulation
- Transderm Scop Patch
- Transparent Film
- Trazodone
- Tresiba
- Tretinoin
- Triamcinolone
- Tricor
- Trulicity
- Ts-xl Stand
- Tslim Insulin Cartridge
- Tubing Kit
- Tuition Due To Illness
- Tutoring
- Tympanometry
- Tyvaso
- Uceris
- Udenyca
- Ulticare Pen Needle
- Ultrasound
- Urinary Catheter
- Ursodiol
- Vacuum Bell Device
- Valacyclovir
- Valcyte
- Valproic Acid Solution
- Vancomycin
- Venlafaxine
- Venofer
- Ventolin
- Verzenio
- Vesicare
- Vfend
- Vicodin
- Victoza
- Vigadrone
- Vimpat
- Vinblastine
- Vincristine
- Viper Plus Supplies
- Vision Therapy
- Visual Reinforcement Audio
- Vital-zymes Complete
- Vitamin
- Vocal Cord Stripping
- Vyvanse
- Wakix
- Wheelchair
- Xalkori
- Xatmep
- Xeljanz
- Xifaxan
- Zarontin
- Zavesca
- Zenatane
- Ziagen
- Ziprasidone Hcl
- Zithromax
- Zofran
- Zolendronic Acid
- Zoloft`
- Zolpidem Tartrate
- Zonisamide
- Zvibe Travel Kit
- Zyprexa
- Zyvox
Oral/Tube Feeding Supplements
- Emp Lightning Sticks
Probiotics
- Pro-bio Gold
- Saccharomyces Boulardii
Vitamins
- 5-methyltetrahydrofolate
- Herx
- Smilax
Fund Definition
Assistance with prescription drug or biologic therapies, devices or other treatment cost shares related to various diseases.
Grant Utilization
HealthWell estimates that patients use an average of $1,880 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:
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To find out if you are eligible for HealthWell’s Pediatric Assistance Fund, please contact us at (800) 675-8416 to speak with a HealthWell representative. 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.
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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.
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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.
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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.
To apply for a grant through our Pediatric Assistance Fund, you must contact a HealthWell representative at 1-800-675-8416. We wish we could say “yes” to every family that comes to us, however, funding is limited. Families must meet HealthWell’s standard income and insurance eligibility criteria to qualify for a grant. Grants are awarded on a case by case basis through the Pediatric Assistance Fund. To apply for a grant, call 1-800-675-8416 anytime Monday through Friday, 9:00 a.m. to 5:00 p.m. (ET). Online applications are not offered or accepted for this fund.
About HealthWell’s Pediatric Assistance Fund
HealthWell’s Pediatric Assistance Fund helps children access the medical treatments they need, regardless of disease type or condition. Through the fund, HealthWell is able to assist families in meeting their cost-sharing obligations to help their child start or continue medical treatments they otherwise would not be able to afford.
You may also visit our Resource List to view other copayment organizations that may provide assistance.