Pulmonary Hypertension - Medicare Access (Medicare patients only)

Status

Open

Fund Type

Copay/Premium

Maximum Award Level

$10,000

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

  • Adcirca
  • Adempas
  • Alyq
  • Ambrisentan
  • Bosentan
  • Cialis
  • Coumadin
  • Epoprostenol
  • Flolan
  • Gonitro
  • Inomax
  • Jantoven
  • Letairis
  • Minitran
  • Nitro Bid
  • Nitro-dur
  • Nitro-time
  • Nitroglycerin
  • Nitrostat
  • Opsumit
  • Opsynvi
  • Orenitram
  • Oxygen
  • Rectiv
  • Remodulin
  • Revatio
  • Sildenafil Citrate
  • Tadalafil
  • Tracleer
  • Treprostinil
  • Tyvaso
  • Uptravi
  • Veletri
  • Ventavis
  • Viagra
  • Warfarin
  • Winrevair

Fund Definition

Assistance with the prescription drugs and biologics used in the treatment of pulmonary hypertension.

Grant Utilization

HealthWell estimates that patients use an average of $6,300 during their 12-month grant period for this disease area.

Consider Premium Assistance

Under this fund, HealthWell can assist with premium costs. Medicare supplemental policies can help with cost shares related to many aspects of your health care. Using a HealthWell grant to cover premiums may be a better option than treatment-specific cost shares.

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.

  • This is a Medicare Access Fund. In order to qualify for assistance through this fund, you must have Medicare. The Foundation will refer patients without Medicare 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.

 

About Pulmonary Hypertension

Pulmonary Hypertension is a term used to describe high blood pressure in the lungs from any cause. PH is a condition that affects the blood vessels in the lungs, causing vessels to become stiff, damaged or narrow, making the right side of the heart work harder to pump blood through. According to the Pulmonary Hypertension Association (PHA), the most common symptoms of PH are breathlessness, fatigue and dizziness, which can be associated with many other conditions such as chronic obstructive pulmonary disease (COPD), asthma or heart disease, making PH difficult to diagnose.

There are five groups of PH based on different causes as defined by the World Health Organization.

  • Pulmonary Arterial Hypertension (PAH)
  • Pulmonary Hypertension Due to Left Heart Disease
  • Pulmonary Hypertension Due to Lung Disease
  • Pulmonary Hypertension Due to Chronic Blood Clots in the Lungs
  • Pulmonary Hypertension Due to Unknown Causes

Regardless of the type, if left untreated, PH can result in right heart failure and death. There is no cure for PH, however, specific therapies are available to manage symptoms and improve quality of life. For additional information and resources, visit the Pulmonary Hypertension Association.

Additional Educational Resources

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