New! Emergency Financial Assistance Fund for PNH Patients Impacted by the COVID-19 Pandemic
During these uncertain times, AAMDSIF is here for you. We recognize the unique concerns of PNH patients and their families during the COVID-19 pandemic, and we are increasing our efforts to provide you with information and support.
AAMDSIF, supported by a grant from Genentech, a member of the Roche Group, have established the COVID-19 Emergency PNH Financial Assistance Program to help eligible PNH patients experiencing financial difficulties directly affected by the pandemic. See below for eligibility requirements, guidelines and instructions on how to apply.
- Patient must be a U.S. citizen or permanent resident and reside in the U.S. or U.S. territories.
- Patient must have a clinically confirmed diagnosis of paroxysmal nocturnal hemoglobinuria (PNH), attested to by the patient or care team member.
- Patient may be insured or uninsured.
- There are no income criteria.
- Patient does not need to have a COVID-19 diagnosis but must explain how the COVID-19/coronavirus pandemic has directly created a financial hardship related to their health or well-being.
- Patients may request up to $350 to help address financial issues created by the pandemic, including but not limited to: unemployment, transportation, childcare, grocery delivery fees, or other expenses directly related to your PNH and the COVID-19 pandemic.
- This grant program will not fund routine or ongoing financial needs that would occur even in the absence of COVID-19; funds have been earmarked only to assist patients with financial hardship that have arisen as a direct result of the pandemic.
- Grant requests will be reviewed and approved by the PNH Patient Committee and their decision will be final. Applicants will be contacted by a Committee member to complete the application.
These limited funds have been made available thanks to the generosity of Genentech. Once the funds have been depleted, this emergency grant program will be closed no later than December 31, 2020.
How to Apply:
Download, fill out, and return the following form (choose either the Microsoft Word or Adobe PDF version):