Immune
Deficiency Foundation
IGIV Compassionate Care Program
(also known as IVIG)
PROGRAM OVERVIEW
The IDF IGIV Compassionate Care Program was started in March 2002 as a temporary assistance program to uninsured or underinsured patients in medical need of IGIV but unable to receive it due to denial of coverage by their health insurance carrier or lack of health insurance coverage. Through this program, an eligible individual may receive up to 3 months of IGIV product, provided product is available. Currently, the three IGIV products available through the program are Carimune by ZLB Bioplasma, Inc., Panglobulin by the American Red Cross and Venoglobulin-S by Alpha Therapeutic. During the three month time period of assistance, an IDF Case Manager will provide resources to assist the individual in the insurance appeal process or in obtaining a health insurance policy, depending on the individual circumstance. If after 3 months, the individual still lacks a health insurance policy for coverage of IGIV therapy, he/she may reapply for an additional 3 months of compassionate care IGIV product for a maximum of 6 months assistance. The individual, however, must provide documentation of efforts made in the appeal process or in obtaining a health insurance policy. This Program does not provide compensation for the administrative costs of IGIV therapy and those arrangements must be made by independently of this assistance.
In order to qualify for IGIV compassionate care assistance, the following
materials are required:
1. Letter of Medical Necessity from patient's treating physician, this should include:
o Patient's diagnosis, including date of birth
o Statement of medical need for IGIV based on the medical judgment of the treating physician
o Dose of IGIV and interval
o Amount of IGIV requested (up to 3 months)
o IGIV brand-name product requested
o Statement regarding patient's financial need for compassionate care IGIV
2. Statement of Financial Need from patient briefly explaining lack of
insurance and/or lack of funds to pay for IGIV
Once the completed application is received at the IDF office, it is reviewed
by the IDF Vice President for Medical Affairs. If approved, the product
is ordered and shipped through the IDF Safety Net Program, according to
the arrangements specified by the requesting physician. The treating physician
and patient are notified of approval and approximate arrival date of the
product by IDF personnel. A separate inventory of IGIV product is maintained
at FFF Enterprises, Inc. specifically for the IDF Compassionate Care Program.
The following file is .pdf format.
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IDF COMPASSIONATE CARE IVIG REQUEST FORM - .pdf format
