CancerCare Co-Payment Assistance Program

Page Reviewed / Updated - Apr. 2015

Overview

CancerCare’s co-payment assistance provides financial help to eligible cancer patients to cover the cost of medications for treating cancer.   Assistance is not meant for insurance premiums.

Cancer drugs can cost several thousand dollars a month, and insurance co-pays for medications can be 20%. This can leave patients with hundreds of dollars a month or more in co-pays. The CancerCare Co-Payment Assistance program helps seniors with direct payments to their medication providers to cover the difference.

This program is not specifically intended for the elderly.

 

Eligibility Requirements

Disabilities / Health

Persons must be diagnosed with one of the following forms of cancer: breast, colorectal, head and neck, lung, pancreatic or renal cell cancer.   Readers should be aware that funding for specific forms of cancer goes through periods of availability followed by months in which no funds are available. 

Financial

CancerCare’s Co-Payment Assistance requires that an applicant's income be less than 4 times the federal poverty level; approximate limits are shown in the table below.   This program does not limit eligibility based on the assets of the applicant.

CancerCare Co-Payment Assistance Income Limits for 2015
Persons in Household 48 States & DC Alaska Hawaii
1 $47,080 $58,880 $54,200
2 $63,720 $79,680 $73,320

Geographic

The senior must be either a U.S. citizen or valid resident alien, and must receive treatment within the U.S.

 

Other Requirements

1) The senior must have Medicare Part D or Medicare Advantage, or other private insurance, and have their medication approved for cancer by the FDA.

2) Seniors must provide evidence of their conditions, their financial needs and insurance. During the application process, they will be asked to provide the following:

  • Copy of Insurance Card
  • Copy of Checking Account Statement
  • Income Verification
  • U.S. Federal Income Tax Return or Social Security/Disability Award Letter
  • Most recent paycheck/pension stub/unemployment check
  • Their Prescription information
  • Their doctor information

 

Personal Factors Not Affecting Eligibility

Age and veteran's discharge status do not play a role in determining eligibility.   Marital status does not directly impact eligibility but presuming both spouses reside in the same residence, income is evaluated for a household of two.

 

Benefits

The benefits limits depend on the extent of need and type of cancer. Usually, annual limits are between $5,000 and $10,000. Typically, individuals that qualify receive between $2,500 and $5,000. The enrollment period is for one year; and re-enrollment each year is possible.

CancerCare sends payment directly to the insurer, pharmacy or doctor once the bills for the medications are received.   Assistance can only be used for cancer treatment medications. Although patients are free to use their medical provider or pharmacy and can switch providers. 

Medications must be approved for cancer by the FDA. Finally a doctor must complete physician verification forms.  For tax purposes, the financial assistance is considered a gift for medical purposes and, therefore, is exempt from taxes.

 

How to Apply

There is no cost to apply for CancerCare Co-Payment Assistance.  The approval process takes 2 to 3 weeks.  One can learn more or apply on their website or by calling 1-866-55-COPAY.