October 3, 2022

500% of the Federal Poverty Level(adjusted for household size and excessiveprice of dwelling areas)Treatments CoveredAceclofenacAcemetacinAllopurinolAmtolmetin GuacilApazoneBufexamacCelecoxibClonixinColchicineColcrysCortisoneDexibuprofenDexketoprofenDiclofenac PotassiumDiclofenac SodiumDiflunisalDipyroneEtodolacEtofenamateEtoricoxibFebuxostatFelbinacFenbufenFenofibrateFenoprofenFloctafenineFlufenamic AcidFlurbiprofenHydrocortisoneIndomethacinKetoprofenKetorolacKrystexxaLodgingLopurinLornoxicamLosartanLosartan PotassiumLoxoprofenLumiracoxibMeclofenamateMeclofernamate SodiumMefenamic AcidMeloxicamMethylprednisoloneMorniflumateNabumetoneNiflumic AcidNimesulideOxaprozinParecoxibPegloticasePiketoprofenPiroxicamPrednisolonePrednisoneProbenecidProglumetacinPropyphenazoneProquazoneSalicylic AcidSalsalateSodium SalicylateSodium ThiosalicylateSulindacTenoxicamTiaprofenic AcidTolmetinTransportation – AirTransportation – BusTransportation – Car MileageTransportation – TaxiTransportation – TrainTriamcinoloneUloricZurampicZyloprimFund Definition

Assistance for journey related to acquiring remedy for gout.Grant Utilization

HealthWell estimates that sufferers use an average of $1,000 all through their 12-month grant duration for this disease place.Do I Qualify?

HealthWell bases eligibility on an character’s scientific, financial and insurance situation. To qualify for HealthWell’s help, applicants need to meet the following eligibility requirements:1.You are being treated for Gout and tour to get hold of treatment.

Through the Gout Travel Fund, we are capable of assist with eligible transportation charges associated with receiving treatment. You might be asked to provide the Foundation with your diagnosis, which have to be demonstrated through a doctor, nurse practitioner, or physician assistant’s signature. Please word, the following pointers must be met in order for the HealthWell Foundation to do not forget compensation:

Transportation Reimbursement:If you or a member of the family/pal drive: Driving distance among your house and drug distribution site (pharmacy or infusion center) or blood monitoring lab website have to be as a minimum 25 miles (50 miles roundtrip), based totally on the most direct route. Please notice, car mileage can be reimbursed at the IRS Standard Business Mileage price, and parking prices will be reimbursed with submission of receipts.

If you operate public transportation or lease a taxi: Transportation charges incurred ought to be at the least $10.00 one way ($20.00 roundtrip), based at the most direct course. For instance, if you use a taxi to get to the drug distribution site (pharmacy or infusion middle) or blood tracking lab website online, the costs incurred ought to be at least $20.00 roundtrip

Proof of Date of Service is required in case you do not have a contemporary Gout copay provide with HealthWell Foundation. An related Date of Service payment should be processed if the patient has a present day Gout copay provide with HealthWell Foundation.

Lodging Reimbursement: Driving distance among your house and drug distribution website ought to be at least one hundred miles (200 miles roundtrip), primarily based at the maximum direct direction.

Hotel room expenses can be reimbursed up to $150.00 a night time per infusion with submission of receipt.

Proof of Date of Service is required if patient does now not have a present day Gout copay supply with HealthWell Foundation. An associated Date of Service charge need to be processed if the affected person has a cutting-edge Gout copay supply with HealthWell Foundation.2.You have coverage and it covers your medication.

To qualify for help from HealthWell, you should have a few shape of medical health insurance (private coverage, Medicare, Medicaid, TriCare, and so on.) that covers part of the value of your treatment. The Foundation will refer patients without prescription coverage to different applications, together with manufacturer patient help applications.3.Your earnings falls inside our hints.

HealthWell assists individuals with earning up to four hundred-500% of the Federal Poverty Level. The Foundation additionally considers the variety in a family and value of dwelling in a particular city or country. If you accept as true with you qualify for help, please name (800) 675-8416 to talk with a HealthWell representative.four.You are receiving remedy in the United States.

If you’re receiving remedy in the U.S. and feature met the eligibility criteria as indexed, you’re geared up to apply! Please be aware that you may be asked to offer a Social Security Number in an effort to create a furnish. This statistics is accrued to eliminate duplicate applications and is kept secure and exclusive.Need A Ride?

HealthWell has partnered with Ride Health to offer transportation services to eligible supply a-o-f.org recipients. Through this service, we hope to do away with the need for provide recipients to pay up-the front for rides to and from appointments relating to their treatment. Fees for services are deducted directly from the affected person’s provide. To examine greater and to determine if you are eligible to utilize this useful resource, touch a HealthWell representative at 800-675-8416 or call us at the least 2 business days in advance of your eligible appointment to agenda this service. 

For our Gout Travel Fund, sufferers may additionally observe for replenishment within twelve months subject to availability of funds.About Gout

Through the Gout Travel Fund, we are able to help with eligible transportation expenses associated with receiving treatment. Gout is a painful and doubtlessly disabling form of arthritis. Gout happens whilst excess uric acid (a normal waste product) collects in the frame, and needle‐like urate crystals deposit within the joints. This may also occur because either uric acid manufacturing will increase or, greater frequently, the kidneys can not get rid of uric acid from the body nicely sufficient. Source: American College of RheumatologyAdditional ResourcesAmerican College of RheumatologyGout Education Society

You may visit our Resource List to view other copayment organizations which can provide assistance.

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