Co-Payment Assistance Fund
CancerCare’s Co-Payment Assistance Fund helps people with head and neck cancer access the prescribed treatments they need.
Program Status: Closed
To receive an email notification when this fund re-opens, click the register button below. You will need to enter your insurance type and primary cancer diagnosis. Select the fund and follow the instructions to be notified once the fund is open.
Register
Eligibility Criteria
Diagnosis: • Head and neck cancer ICD-10 code is C76. View list of ICD-10 codes » • Primary cancer diagnosis must be the same as the fund and verified by the prescribing physician. Download Physician Verification Form »
Insurance: • Patient must have health care insurance (any type)
Income: • Income level must be at or below 500% of the Federal Poverty Level (FPL)
Citizenship: • Must have a valid Social Security number to apply for assistance and receive treatment in the United States
Treatments Covered: • Patient must be in active treatment or have a treatment plan in place prior to applying for assistance. Read more in our FAQs »
Retroactive policy
CCAF will consider retroactive reimbursement for first time applicants actively receiving a covered treatment. Our retroactive assistance will only consider dates of service within 60 days prior to the date we approve the application. Conditional approvals are not eligible for retroactive coverage.
If the initial grant amount is exhausted before the grant end date, a request for additional funds up to the program CAP amount can be submitted.
Additional Services
CancerCare offers services including counseling, support groups, financial assistance, workshops and publications.
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