Eligibility Pre-screen

Search for a disease fund by typing in the name of a disease or the name of a medication used to treat a disease.

Select Disease Fund Medication name

An existing patient was found in our records. Fields will be pre-populated with the existing information. Please review the current values and edit as needed.

The patient is already enrolled in the selected disease fund.

Please contact the PAN call center at 1-866-316-7263 to complete the enrollment.