Eligibility
To qualify for assistance, patients must meet certain criteria related to their financial, medical, and insurance situation:
1. Income Limits
Individuals or families with incomes of up to four times the federal poverty level may qualify (see chart below). The Foundation may also consider the cost of living in your particular city or state.
| Persons in Family or Household |
48 Contiguous States and DC |
Alaska | Hawaii |
|---|---|---|---|
| * Note, these amounts are four (4) times the 2012 Federal Poverty Level as defined by the United States Department of Health and Human Services. | |||
| 1 | $45,960 | $57,400 | $52,920 |
| 2 | $62,040 | $77,520 | $71,400 |
| 3 | $78,120 | $97,640 | $89,880 |
| 4 | $94,200 | $117,760 | $108,360 |
| 5 | $110,280 | $137,880 | $126,840 |
| 6 | $126,360 | $158,000 | $145,320 |
| 7 | $142,440 | $178,120 | $163,800 |
| 8 | $158,520 | $198,240 | $182,280 |
| For each additional person, add: | $4,020 | $5,030 | $4,620 |
2. Diagnosis and Treatment
- You must be diagnosed with one of the cancer types that the Foundation covers (view diagnoses below).
- Your diagnosis must be verified by a doctor. Your doctor must complete and sign our physician verification form.
- You must currently be in active chemotherapy or targeted treatment when you apply to the Foundation and at the time of approval.
- You must receive treatment in the United States.
Is your diagnosis not listed? We can still help.
Breast Cancer
Funding is currently unavailableBreast Cancer (Metastatic)
Funding is currently unavailableColon or Colorectal Cancer
Funding is currently unavailableGastric Cancer
Funding is availableGlioblastoma
Funding is availableHead and Neck Cancer
Funding is currently unavailableNon-Small Cell Lung Cancer
Funding is currently unavailablePancreatic Cancer
Funding is currently unavailableProstate (Metastatic)
Funding is currently unavailableProstate Cancer
Funding is currently unavailableRenal Cell Cancer
Funding is currently unavailable
The Foundation currently covers all FDA-approved chemotherapy and targeted treatment drugs as indicated to treat the specific cancer types that currently have funding.
3. Insurance Coverage
You must be covered by private insurance* or an employer-sponsored health plan or have Medicare Part B, Medicare Part D, or a Medicare Advantage Plan (Medicare C).
If you are uninsured (do not have any insurance or medical plan that covers prescription medication) 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.
*For privately insured patients, please contact the drug company who manufactures your medication prior to contacting our foundation. Drug companies have several types of programs available to assist patients taking their medications. The foundation is a charity with limited resources; therefore, we are now requesting that all patients with private insurance explore this option prior to applying to our foundation.
Our co-payment specialists are available to assist you if you have any questions about this process.