In order to be eligible for assistance, patients must complete and sign an application and HIPAA Authorization form, as well as provide proof of income. We will review your application and forms on a first-come, first-served basis to the extent that funding is available.
Please note: As a nonprofit organization, we cannot guarantee that funding will always be available for a particular diagnosis. If we are unable to provide co-payment assistance, however, we will refer you to other organizations that may be able to help.
To qualify for assistance, you must meet certain financial, medical and insurance criteria.
- Individuals or families with an adjusted gross income of up to four times the federal poverty level may qualify for assistance. CancerCare® Co-Payment Assistance Foundation (CCAF) may also consider the cost of living in your particular city or state. Income verification is required as part of the application process.
- You must have private insurance or Medicare that covers a portion of the prescribed chemotherapy or targeted treatment.
- You must be diagnosed with one of the cancer types that CancerCare® Co-Payment Assistance Foundation currently covers. The treating doctor must submit a verification form confirming your diagnosis and medications. Your diagnosis must be verified by a doctor. Your doctor must complete and sign our physician verification form.
- You must currently be undergoing chemotherapy or prescribed and/or using a targeted treatment drug when you apply to CCAF, and at the time of approval.
- You must be covered by private insurance or an employer-sponsored health plan, or you must have Medicare Part B, Medicare Part D or a Medicare Advantage Plan (Medicare C).
Please note: If you have private insurance, before you contact CCAF, please contact the drug company that manufactures your medication. Drug companies have several programs that may help you.
If you are uninsured (do not have any insurance or medical plan that covers your prescription medicines), you are not eligible for co-payment assistance. However, we encourage you to contact us so that we can refer you to other organizations or patient assistance programs.
- You must be receiving treatment in the United States.
- You must be a U.S. citizen or legal resident.
Eligible individuals will receive an application packet with instructions on how to apply for assistance. Our co-payment specialists are available to assist you if you have any questions about this process.
We provide easy access to enrollment and can provide same-day approval. To begin the enrollment process, go to our PORTAL site.
If we currently do not have funding for your diagnosis, please visit our Resources page.