How to Apply

Who Can Apply?

Patients, their family members, or their advocates may apply to the CancerCare Co-Payment Assistance Foundation.

Step 1

Before you contact us, please have the following information available:

  • Patient Information (name, address, telephone number, social security number, date of birth)
  • Patient Insurance Information or Insurance Card
  • Patient Income Information (total household income and number of people in the household including the patient)
  • Your doctor's (prescribing physician) information (name, address, telephone number and contact name)
  • The medication or drug name prescribed to you

If you are unclear about any of these items, go to Step 2 and contact us directly.

Step 2

Call our toll-free number, 1-866-55-COPAY (866-552-6729) from 9 a.m. to 7 p.m. (Eastern Time) Monday through Thursday, and 9 a.m. to 5 p.m. (Eastern Time) on Friday.

For expanded hours in your time zone, please click here.

Eastern: 9 a.m. – 7 p.m., Monday – Thursday; 9 a.m. – 5 p.m., Friday
Central: 8 a.m. – 6 p.m., Monday – Thursday; 8 a.m. – 4 p.m., Friday
Mountain: 7 a.m. – 5 p.m., Monday – Thursday; 7 a.m. – 3 p.m., Friday
Pacific: 6 a.m. – 4 p.m., Monday – Thursday; 6 a.m. – 2 p.m., Friday

 

Questions? Please visit our Frequently Asked Questions, or email information@cancercarecopay.org.