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 with the same information was found in our records. Fields will be prepopulated with that data. Please review 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.


Pre-Screen Eligibility: Wait List ID