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CancerCare Co-Payment Assistance Program
Page Reviewed / Updated - August 09, 2010
Table of Contents |
- Overview
- Eligibility Requirements
- Disabilities / Health
- Financial
- Geographic
- Other Requirements
- Personal Factors Not Affecting Eligibility
- Benefits
- How to Apply
Overview
CancerCare’s Co-Payment Assistance Foundation 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 many forms of cancer, which includes 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. To see a complete list of cancer diagnoses this program covers, as well as the availability of funding, click here.
Financial
CancerCare’s Co-Payment Assistance requires that an applicant's income be less than four or five times the Federal Poverty Level, abbreviated as FPL (depending on the diagnosis). 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 2017 | |||
|---|---|---|---|
| Persons in Household | 48 States & DC | Alaska | Hawaii |
| 1 at 400% FPL | $48,240 | $60,240 | $55,440 |
| 1 at 500% FPL | $60,300 | $75,300 | $69,300 |
| 2 at 400% FPL | $64,960 | $81,160 | $74,680 |
| 2 at 500% FPL | $81,200 | $101,450 | $93,350 |
To see diagnosis and the corresponding FPL, click here.
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, Medicare Advantage, or TRICARE, or other private insurance.
2) Medication must be approved for cancer by the FDA.
3) 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 benefit limits depend on the extent of need and type of cancer. (Each disease has a different grant amount.) 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. Patients are free to use their medical provider or pharmacy and can switch providers at any time.
Finally, a doctor must complete physician verification forms. For tax purposes, financial assistance is considered a gift for medical purposes. Therefore, it is exempt from taxes.
For individuals who are applying for assistance for the first time and are already receiving cancer treatment, retroactive assistance may be available. This is determined on an individual basis. Make note, only treatments within 60 days of one’s approval of application will be considered.
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.