Financial Assistance for Pulmonary Hypertension Patients with Medicare, Medicaid & Military Benefits

 financial assistance for PAH patients

Assistance Now Available.

Where to get financial assistance for the very expensive drugs used to treat Pulmonary Arterial Hypertension remains a hot topic. With an average treatment cost of around $100,000 per PAH patient per year, financial assistance is in great demand.

Pulmonary Hypertension patients that are uninsured or privately insured have options for financial assistance. Click here to learn more about foundations currently offering assistance. However, patients on government plans like Medicare, Medicaid or Military Benefits are often left out of drug manufacturer assistance programs. The Patient Advocate Foundation (PAF) is one fund that can help this population of PAH patients.

What are Patient Advocate Foundation’s Eligibility Requirements?

  • To receive any PAH treatment a patient should first have a right heart catheterization to confirm the diagnosis. While PAF does not specifically state that a right heart catheterization is required to receive funding they do require a “confirmed diagnosis of Pulmonary Hypertension”.
  • The fund is open to patients within the United States insured by Medicare, Medicaid or Military Benefits.
  • The medication must be covered by the patient’s insurance and a prior authorization must be obtained. Your PAH specialist’s office will obtain the required prior authorization.
  • Patient’s income must be below 400% of the Federal Poverty Guideline (FPG). For 2018 for an individual living in one of the 48 contiguous states the income must be less than $48,560 per year. The income limit goes up for each additional family member and Alaska and Hawaii have slightly different requirements. The cost of living in your area is also considered. You can learn more about the Federal Poverty Guideline here https://aspe.hhs.gov/poverty-guidelines.

How Can PAH Patients Apply for Patient Advocate Foundation Assistance?

Patients that meet the above criteria can apply online at www.copays.org or by calling 1-866-512-3861.

What Amount of Financial Assistance Can Pulmonary Hypertension Patients Receive?

The maximum amount of assistance per year for 2018 is $9,000.

PAH patients that do not meet the criteria for this assistance program and are struggling to afford their medications should reach out to their PAH specialists. These specialty clinics will have the most up to date information on available programs and research protocols that patients may qualify for. Never discontinue treatment without speaking with your provider as this may cause serious side effects.