Eligibility

Who is Eligible?

The CancerCare Co-Payment Assistance Foundation takes into account a person's financial and insurance situation when determining who is eligible for assistance.

The criteria used to determine if you are eligible are:

  • Financial Information
    • Individuals or families with incomes of up to four times the federal poverty level may qualify. Click here to view the poverty level chart. The Foundation may also consider the cost of living in your particular city or state.

    CancerCare Co-Payment Assistance Foundation Income Limits*

    Persons in Family
    or Household    		 48 Contiguous
    States and DC    		 Alaska Hawaii
    1 $43,560 $54,400 $50,160
    2 $58,840 $73,520 $67,720
    3 $74,120 $92,640 $85,280
    4 $89,400 $111,760 $102,840
    5 $104,680 $130,880 $120,400
    6 $119,960 $150,000 $137,960
    7 $135,240 $169,120 $155,520
    8 $150,520 $188,240 $173,080
    For each additional
    person, add:    		 $15,280 $19,120 $17,560

    * Note, these amounts are four (4) times the 2011 Federal Poverty Level as defined by the United States Department of Health and Human Services

  • Diagnosis and Treatment
    • You must be diagnosed with one of the cancer types that the Foundation covers. Click here for a listing of diagnoses we currently cover, —and—
    • Your diagnosis must be verified by a doctor. Your doctor must complete and sign our physician verification form, —and—
    • You must receive treatment dispensed in the United States, —and—
    • The medication that you are taking must be approved by the Food and Drug Administration (FDA) for cancer.
  • Insurance Coverage
    • You must be covered by private insurance or an employer-sponsored health plan, —or—
    • Have Medicare Part B, Medicare Part D, Medicare Supplementary Health Insurance ("Medigap") or Medicare Advantage Plan
    • 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.

The Foundation grants assistance on a first-come, first-served basis, to the extent that funding is available.



How it Works

Step 1: Apply

  • Call 1-866-55-COPAY to determine if you are eligible and begin the application process.

Step 2: Award Determination

  • We will send you a form to complete and return to us.
  • We will send you a form that your doctor will need to complete and return to us.

  • If approved, you will receive an Award Determination letter by mail with instructions for accessing your award.

    Important Note: The Foundation will only send an application form to you after you call 1-866-552-6729 to speak with one of our specialists so that we can determine if you are eligible to apply. However, you may view samples of our Application (PDF) and of the Physician Verification Form (PDF).

    Once you receive an Application you will also be required to send copies of a number of financial and other documents—view a list of those required documents in the Application Checklist (PDF).

Step 3: Payments

  • Payments generally are sent directly to an insurer, pharmacy, doctor or other health care provider upon receipt of bills or other documentation.

The Foundation does not restrict the medical provider or pharmacy selected by the patient. You may change your providers at any time during your award period.

For more information, please contact us.

 

The CancerCare Co-Payment Assistance Foundation reserves the right to change any or all parts of its program at any time with or without notice.