Primary Immune Deficiency
Primary Immune (PI) Deficiency is a chronic disorder of the body’s immune system, which means people are more likely to become sick with infections. People with PI are more likely to also have autoimmune disorders. There are over 400 identified types of immune deficiencies and often it takes 7 to 10 years for a person to be diagnosed. It is estimated that 1 in 2,000 people are impacted in the U.S.
Assistance Information
Dollar cap is shared across assistance types.
Other Insurance — Up to 500% FPL
| Assistance Type | Status | Max Amount |
|---|---|---|
| Copay | At Capacity | $3,800 |
| Medical Expenses | At Capacity | $3,800 |
| Travel Expense | At Capacity | $500 |
Private Insurance — Up to 500% FPL
| Assistance Type | Status | Max Amount |
|---|---|---|
| Copay | At Capacity | $3,800 |
| Medical Expenses | At Capacity | $3,800 |
| Premium | At Capacity | $3,800 |
| Travel Expense | At Capacity | $500 |
Diagnosis Codes
- D70.0 Congenital agranulocytosis
- D71 Functional disorders of polymorphonuclear neutrophils
- D72.0 Genetic anomalies of leukocytes
- D76 Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue
- D76.1 Hemophagocytic lymphohistiocytosis
- D80 Immunodeficiency with predominantly antibody defects
- D80.0 Hereditary hypogammaglobulinemia
- D80.1 Nonfamilial hypogammaglobulinemia
- D80.2 Selective deficiency of immunoglobulin A [IgA]
- D80.3 Selective deficiency of immunoglobulin G [IgG] subclasses
- D80.4 Selective deficiency of immunoglobulin M [IgM]
- D80.5 Immunodeficiency with increased immunoglobulin M [IgM]
- D80.6 Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia
- D80.7 Transient hypogammaglobulinemia of infancy
- D80.8 Other immunodeficiencies with predominantly antibody defects
- D80.9 Immunodeficiency with predominantly antibody defects, unspecified
- D81 Combined immunodeficiencies
- D81.0 Severe combined immunodeficiency [SCID] with reticular dysgenesis
- D81.1 Severe combined immunodeficiency [SCID] with low T- and B-cell numbers
- D81.2 Severe combined immunodeficiency [SCID] with low or normal B-cell numbers
- D81.3 Adenosine deaminase [ADA] deficiency
- D81.30 Adenosine deaminase deficiency, unspecified
- D81.31 Severe combined immunodeficiency due to adenosine deaminase deficiency
- D81.32 Adenosine deaminase 2 deficiency
- D81.39 Other adenosine deaminase deficiency
- D81.4 Nezelof's syndrome
- D81.5 Purine nucleoside phosphorylase [PNP] deficiency
- D81.6 Major histocompatibility complex class I deficiency
- D81.7 Major histocompatibility complex class II deficiency
- D81.8 Other combined immunodeficiencies
- D81.81 Biotin-dependent carboxylase deficiency
- D81.810 Biotinidase deficiency
- D81.818 Other biotin-dependent carboxylase deficiency
- D81.819 Biotin-dependent carboxylase deficiency, unspecified
- D81.82 Activated Phosphoinositide 3-kinase Delta Syndrome [APDS]
- D81.89 Other combined immunodeficiencies
- D81.9 Combined immunodeficiency, unspecified
- D82 Immunodeficiency associated with other major defects
- D82.0 Wiskott-Aldrich syndrome
- D82.1 Di George's syndrome
- D82.2 Immunodeficiency with short-limbed stature
- D82.3 Immunodeficiency following hereditary defective response to Epstein-Barr virus
- D82.4 Hyperimmunoglobulin E [IgE] syndrome
- D82.8 Immunodeficiency associated with other specified major defects
- D82.9 Immunodeficiency associated with major defect, unspecified
- D83 Common variable immunodeficiency
- D83.0 Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function
- D83.1 Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
- D83.2 Common variable immunodeficiency with autoantibodies to B- or T-cells
- D83.8 Other common variable immunodeficiencies
- D83.9 Common variable immunodeficiency, unspecified
- D84 Other immunodeficiencies
- D84.0 Lymphocyte function antigen-1 [LFA-1] defect
- D84.8 Other specified immunodeficiencies
- D84.81 Immunodeficiency due to conditions classified elsewhere
- D84.82 Immunodeficiency due to drugs and external causes
- D84.821 Immunodeficiency due to drugs
- D84.822 Immunodeficiency due to external causes
- D84.89 Other immunodeficiencies
- D84.9 Immunodeficiency, unspecified
- D89 Other disorders involving the immune mechanism, not elsewhere classified
- D89.0 Polyclonal hypergammaglobulinemia
- D89.1 Cryoglobulinemia
- D89.2 Hypergammaglobulinemia, unspecified
- D89.3 Immune reconstitution syndrome
- D89.4 Mast cell activation syndrome and related disorders
- D89.40 Mast cell activation, unspecified
- D89.41 Monoclonal mast cell activation syndrome
- D89.42 Idiopathic mast cell activation syndrome
- D89.43 Secondary mast cell activation
- D89.49 Other mast cell activation disorder
- D89.8 Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.81 Graft-versus-host disease
- D89.810 Acute graft-versus-host disease
- D89.811 Chronic graft-versus-host disease
- D89.812 Acute on chronic graft-versus-host disease
- D89.813 Graft-versus-host disease, unspecified
- D89.82 Autoimmune lymphoproliferative syndrome [ALPS]
- D89.89 Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.9 Disorder involving the immune mechanism, unspecified
- E70.330 Chediak-Higashi syndrome
- G11.3 Cerebellar ataxia with defective DNA repair
Covered Medications
- Abatacept
- Orencia ClickJect
- Orencia
- Belumosudil Mesylate
- Rezurock
- Elapegademase-lvlr
- Revcovi
- Ibrutinib
- Imbruvica
- Bivigam
- Flebogamma DIF
- Gammagard S/D Less IgA
- Gammaplex
- Immune Globulin (Human)
- Octagam
- Privigen
- Gammagard ERC
- Gammagard
- Gammaked
- Gamunex-C
- Immune Globulin (Human)
- Cuvitru
- Hizentra
- Immune Globulin (Human)
- Cutaquig
- Immune Globulin (Human)-hipp
- Hyqvia
- Immune Globulin-Hyaluronidase
- Immune Globulin (Human)-ifas
- Panzyga
- Immune Globulin (Human)-klhw
- Xembify
- Asceniv
- Immune Globulin (Human)-slra
- Actimmune
- Interferon Gamma-1B
- Joenja
- Leniolisib Phosphate
- Jakafi XR
- Jakafi
- Ruxolitinib Phosphate ER
- Ruxolitinib Phosphate
- Alyglo
- Immune Globulin (Human)-stwk
- Mavorixafor
- Xolremdi
- Axatilimab-csfr
- Niktimvo
- Tocilizumab-aazg
- Tyenne
- Remestemcel-L-rknd
- Ryoncil <12.5kg
- Ryoncil 100kg to <112.5kg
- Ryoncil 112.5kg to <125kg
- Ryoncil 12.5kg to <25kg
- Ryoncil 125kg to <137.5kg
- Ryoncil 137.5kg to <150kg
- Ryoncil 25kg to <37.5kg
- Ryoncil 37.5kg to <50kg
- Ryoncil 50kg to <62.5kg
- Ryoncil 62.5kg to <75kg
- Ryoncil 75kg to <87.5kg
- Ryoncil 87.5kg to <100kg
- Inebilizumab-cdon
- Uplizna
- Emapalumab-lzsg
- Gamifant
- Immune Globulin (Human)-dira
- Yimmugo
- Cromolyn Sodium
- Gastrocrom
- raNITIdine HCl
- Immune Globulin (Human)-kthm
- Qivigy
Resources
Immune Deficiency Foundation
Jeffrey Modell Foundation
Caregiver Resources
ARCH National Respite Network and Resource Center
National Alliance for Caregiving
Other Patient Assistance Organizations
Primary Immune (PI) Deficiency is a chronic disorder of the body’s immune system, which means people are more likely to become sick with infections. People with PI are more likely to also have autoimmune disorders. There are over 400 identified types of immune deficiencies and often it takes 7 to 10 years for a person to be diagnosed. It is estimated that 1 in 2,000 people are impacted in the U.S.
Assistance Information
Dollar cap is shared across assistance types.
Public Insurance — Up to 500% FPL
| Assistance Type | Status | Max Amount |
|---|---|---|
| Copay | At Capacity | $3,800 |
| Medical Expenses | At Capacity | $3,800 |
| Premium | At Capacity | $3,800 |
| Travel Expense | At Capacity | $500 |
Diagnosis Codes
- D70.0 Congenital agranulocytosis
- D71 Functional disorders of polymorphonuclear neutrophils
- D72.0 Genetic anomalies of leukocytes
- D76 Other specified diseases with participation of lymphoreticular and reticulohistiocytic tissue
- D76.1 Hemophagocytic lymphohistiocytosis
- D80 Immunodeficiency with predominantly antibody defects
- D80.0 Hereditary hypogammaglobulinemia
- D80.1 Nonfamilial hypogammaglobulinemia
- D80.2 Selective deficiency of immunoglobulin A [IgA]
- D80.3 Selective deficiency of immunoglobulin G [IgG] subclasses
- D80.4 Selective deficiency of immunoglobulin M [IgM]
- D80.5 Immunodeficiency with increased immunoglobulin M [IgM]
- D80.6 Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia
- D80.7 Transient hypogammaglobulinemia of infancy
- D80.8 Other immunodeficiencies with predominantly antibody defects
- D80.9 Immunodeficiency with predominantly antibody defects, unspecified
- D81 Combined immunodeficiencies
- D81.0 Severe combined immunodeficiency [SCID] with reticular dysgenesis
- D81.1 Severe combined immunodeficiency [SCID] with low T- and B-cell numbers
- D81.2 Severe combined immunodeficiency [SCID] with low or normal B-cell numbers
- D81.3 Adenosine deaminase [ADA] deficiency
- D81.30 Adenosine deaminase deficiency, unspecified
- D81.31 Severe combined immunodeficiency due to adenosine deaminase deficiency
- D81.32 Adenosine deaminase 2 deficiency
- D81.39 Other adenosine deaminase deficiency
- D81.4 Nezelof's syndrome
- D81.5 Purine nucleoside phosphorylase [PNP] deficiency
- D81.6 Major histocompatibility complex class I deficiency
- D81.7 Major histocompatibility complex class II deficiency
- D81.8 Other combined immunodeficiencies
- D81.81 Biotin-dependent carboxylase deficiency
- D81.810 Biotinidase deficiency
- D81.818 Other biotin-dependent carboxylase deficiency
- D81.819 Biotin-dependent carboxylase deficiency, unspecified
- D81.82 Activated Phosphoinositide 3-kinase Delta Syndrome [APDS]
- D81.89 Other combined immunodeficiencies
- D81.9 Combined immunodeficiency, unspecified
- D82 Immunodeficiency associated with other major defects
- D82.0 Wiskott-Aldrich syndrome
- D82.1 Di George's syndrome
- D82.2 Immunodeficiency with short-limbed stature
- D82.3 Immunodeficiency following hereditary defective response to Epstein-Barr virus
- D82.4 Hyperimmunoglobulin E [IgE] syndrome
- D82.8 Immunodeficiency associated with other specified major defects
- D82.9 Immunodeficiency associated with major defect, unspecified
- D83 Common variable immunodeficiency
- D83.0 Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function
- D83.1 Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
- D83.2 Common variable immunodeficiency with autoantibodies to B- or T-cells
- D83.8 Other common variable immunodeficiencies
- D83.9 Common variable immunodeficiency, unspecified
- D84 Other immunodeficiencies
- D84.0 Lymphocyte function antigen-1 [LFA-1] defect
- D84.8 Other specified immunodeficiencies
- D84.81 Immunodeficiency due to conditions classified elsewhere
- D84.82 Immunodeficiency due to drugs and external causes
- D84.821 Immunodeficiency due to drugs
- D84.822 Immunodeficiency due to external causes
- D84.89 Other immunodeficiencies
- D84.9 Immunodeficiency, unspecified
- D89 Other disorders involving the immune mechanism, not elsewhere classified
- D89.0 Polyclonal hypergammaglobulinemia
- D89.1 Cryoglobulinemia
- D89.2 Hypergammaglobulinemia, unspecified
- D89.3 Immune reconstitution syndrome
- D89.4 Mast cell activation syndrome and related disorders
- D89.40 Mast cell activation, unspecified
- D89.41 Monoclonal mast cell activation syndrome
- D89.42 Idiopathic mast cell activation syndrome
- D89.43 Secondary mast cell activation
- D89.49 Other mast cell activation disorder
- D89.8 Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.81 Graft-versus-host disease
- D89.810 Acute graft-versus-host disease
- D89.811 Chronic graft-versus-host disease
- D89.812 Acute on chronic graft-versus-host disease
- D89.813 Graft-versus-host disease, unspecified
- D89.82 Autoimmune lymphoproliferative syndrome [ALPS]
- D89.89 Other specified disorders involving the immune mechanism, not elsewhere classified
- D89.9 Disorder involving the immune mechanism, unspecified
- E70.330 Chediak-Higashi syndrome
- G11.3 Cerebellar ataxia with defective DNA repair
Covered Medications
- Abatacept
- Orencia ClickJect
- Orencia
- Belumosudil Mesylate
- Rezurock
- Elapegademase-lvlr
- Revcovi
- Ibrutinib
- Imbruvica
- Bivigam
- Flebogamma DIF
- Gammagard S/D Less IgA
- Gammaplex
- Immune Globulin (Human)
- Octagam
- Privigen
- Gammagard ERC
- Gammagard
- Gammaked
- Gamunex-C
- Immune Globulin (Human)
- Cuvitru
- Hizentra
- Immune Globulin (Human)
- Cutaquig
- Immune Globulin (Human)-hipp
- Hyqvia
- Immune Globulin-Hyaluronidase
- Immune Globulin (Human)-ifas
- Panzyga
- Immune Globulin (Human)-klhw
- Xembify
- Asceniv
- Immune Globulin (Human)-slra
- Actimmune
- Interferon Gamma-1B
- Joenja
- Leniolisib Phosphate
- Jakafi XR
- Jakafi
- Ruxolitinib Phosphate ER
- Ruxolitinib Phosphate
- Alyglo
- Immune Globulin (Human)-stwk
- Mavorixafor
- Xolremdi
- Axatilimab-csfr
- Niktimvo
- Tocilizumab-aazg
- Tyenne
- Remestemcel-L-rknd
- Ryoncil <12.5kg
- Ryoncil 100kg to <112.5kg
- Ryoncil 112.5kg to <125kg
- Ryoncil 12.5kg to <25kg
- Ryoncil 125kg to <137.5kg
- Ryoncil 137.5kg to <150kg
- Ryoncil 25kg to <37.5kg
- Ryoncil 37.5kg to <50kg
- Ryoncil 50kg to <62.5kg
- Ryoncil 62.5kg to <75kg
- Ryoncil 75kg to <87.5kg
- Ryoncil 87.5kg to <100kg
- Inebilizumab-cdon
- Uplizna
- Emapalumab-lzsg
- Gamifant
- Immune Globulin (Human)-dira
- Yimmugo
- Cromolyn Sodium
- Gastrocrom
- raNITIdine HCl
- Immune Globulin (Human)-kthm
- Qivigy
Resources
Immune Deficiency Foundation
Jeffrey Modell Foundation
Caregiver Resources
ARCH National Respite Network and Resource Center
National Alliance for Caregiving
Other Patient Assistance Organizations
