Cancercare Co-Payment Assistance Foundation : Can I apply for assistance online?

Cancercare help people with cancer overcome financial access and treatment barriers by assisting them with co-payments for their prescribed treatments. Cancercare offer easy-to-access, same-day approval over the phone and online.

Can I apply for assistance online?

Yes. You, or a representative on your behalf, can enroll online. You will need to have the following information available when you apply online:

• Full legal name
• Primary/mailing address
• Phone number
• Email address
• Social Security Number
• Date of birth
• Diagnosis or condition
• Product or medication
• Household income
• Number of dependents
• Health insurance provider
• Treating physician’s name

Please note, when you apply online, we will attempt to verify your income through an electronic income verification process. As part of our compliance program, you may be asked to submit additional income verification.

Can I return my forms and information via email or fax?

Yes. You may return by email (information@cancercarecopay.org) or by fax (212-601-9760).

If you already have an account through our portal, you can log in and upload your documents. Once you log in, click on My Patient Profile/My Account and Create Attachment. If you do not have an account and would like to create one

How do I check the status of my application?

Online: Check your enrollment status and fund balance.

Phone: You, or a representative on your behalf, can use our auto-attendant feature by calling 866-552-6729 (select option 3).

• You are enrolled for up to one year from the time you are approved.

How can I reapply for assistance?

If your status with CCAF has remained active throughout the year, you will receive a renewal notice in the mail 60 days before the date your grant ends, with instructions for reapplying for continued assistance.

If funds are no longer available, we will notify you and provide you with resources to other foundations and organizations that may be able to help.

What are the income requirements?

Individuals or families with an adjusted gross income of up five times the federal poverty level may qualify for assistance (view the Federal Poverty Guidelines). Income verification is required as part of the application process.

CCAF understands that cancer is an expensive illness and the family income can change drastically due to a cancer diagnosis. If your income is over our criteria, please call and discuss your specific financial situation with one of our co-payment specialists. If we are unable to assist you, we may be able to provide you with other vital resources and support services.

CancerCare Co-Payment Assistance Foundation has limited resources and eligibility is determined based on financial need. Therefore, we must verify your income to determine if you are eligible for assistance within the guidelines of a particular fund.

If I have Medicare Part D, can I still apply?

Yes. CancerCare Co-Payment Assistance Foundation can help if you meet all other medical and financial criteria. This assistance will count toward your true out-of-pocket costs (TrOOP) to get you through the Medicare Part D coverage gap. Please check for specific insurance eligibility requirements for each fund.

If you have a low income (up to 150% of the federal poverty level) with limited assets and are enrolled in a Medicare Part D plan, you may be eligible for Low Income Subsidy (LIS) assistance. If you qualify for LIS, your out-of-pocket expenses will be less. You can find out if you qualify by calling 800-772-1213 or by visiting cms.gov.

How do I contact the CancerCare Co-Payment Assistance Foundation (CCAF)?

You, or a representative on your behalf, can contact CCAF by calling 866-55-COPAY (866-552-6729). Co-payment specialists are available from 9 a.m.–7 p.m. (EST) Monday through Thursday, and 9 a.m.–5 p.m. (EST) on Friday.

When approved, you are awarded an initial grant amount. If the initial grant amount is exhausted before the grant end date, a request for additional funds can be submitted.