Definition
The Leukemia & Lymphoma Society’s (LLS) Co-Pay Assistance Program helps financially needy cancer patients pay for their cancer treatment co-payments, health insurance premiums and many of their prescription co-payments.
Program Overview
The LLS Co-Payment Assistance Program is for seniors or persons of any age who have Leukemia, Lymphoma, or related blood illnesses, and have insurance. Compared with many other forms of assistance, the income eligibility threshold, at 500% of the federal poverty level, is fairly high for this program. A family’s assets are not a factor in eligibility.
One must have health and prescription insurance to participate in the LLS Co-Payment Assistance Program.
Persons enrolled in the Co-Pay Assistance Program are free to choose their own doctors, insurance, and other providers, as well as their treatment-related medications. They are also able to change their decisions without impacting their eligibility.
The senior’s doctor must confirm the diagnosis and that the drugs or physician visits for which they have applied for assistance are being used to treat a cancer currently covered in LLS’s plan. The program also helps seniors pay for their insurance premiums and prescription co-pay costs, but does not cover prescribed devices, laboratory, and diagnostic services.
The program has a fast approval process. This makes the LLS Co-Payment Assistance program a solution (or part of a solution) for those families whose needs have a defined length of time, such as while they are waiting to sell a house.
Benefits have a lifetime maximum, and applicants should be aware the lifetime maximums can change with the availability of funds. For example, the maximum allowable assistance might increase from $5,000 to $8,000, and persons previously at the limit might again become eligible. The reverse can apply as well; while enrolled, the maximum allowance may be reduced.
For tax purposes, the financial assistance is considered a gift for medical purposes. Therefore, it is exempt from taxes.
Eligibility Requirements
Disabilities / Health
In order to qualify for the LLS Co-Pay Assistance Program, seniors must be diagnosed by a physician as having one of the blood cancer conditions listed below. A doctor must also confirm that the prescribed drugs and physician visits for which they have applied for co-payment are being used to treat a cancer.
- Chronic Lymphocytic Leukemia
- Hodgkin Lymphoma
- Non-Hodgkin Lymphoma
- Mantle Cell Lymphoma
- Myelodysplastic Syndromes (MDS), including Chronic Myelogenous Leukemia
- Myeloma
- Waldenstrom Macroglobulinemia
Financial
To be eligible for LLP Co-Pay Assistance Program, the individual in need of care’s household income must be equal to or less than 500% of the U.S. Federal Poverty threshold. In 2017, these limits are $60,300 or $81,200 for an individual or a couple, respectively. Persons residing in Alaska, Hawaii, or in cities with usually high costs of living may be eligible with incomes over these amounts. Program applicants are required to provide documentation that verifies their household income. A family’s assets, including the value of their home, are not a factor in eligibility.
Insurance
An individual must have health insurance and / or prescription drug coverage.
Personal Factors Not Affecting Eligibility
There are no age restrictions for the LLS Co-Pay Assistance Program. Nor does the applicant’s veterans discharge or marital status impact their eligibility. The program is open to all U.S. citizens and residents.
Benefits
Most commonly, the benefits of the LLS Co-Pay Assistance Program are payments made directly to the pharmacy, doctor or insurance provider. On occasion, payments will be made directly to the individual in need of care. Assistance is for insurance and medication co-payments only. The amount of assistance provided differs with each individual and type of cancer and the available funds. Lifetime maximums assistance to any individual is usually between $2,500 and $10,000.
How to Apply
One can learn more about this program on the Leukemia & Lymphoma Society’s website.
There are no costs associated with the application or with participation in the program. Within one week to 10 days of receiving the completed application, the LLS Co-Pay Assistance Program will notify applicants of their determination. One can apply here or on the phone by calling 877-557-2672.
The following materials and information are necessary for the application.
- Patient’s Social Security Number & Date of Birth
- Diagnosis Name
- Name of Insurance Companies including group, policy and ID number, as well as Medicare/Medicaid
- Name of Pharmacy, Phone & Fax Numbers
- Name of Physician, Phone & Fax Numbers
- Financial Documents, such as the patient’s most recent Tax Returns, 1099s, S.S., Benefit Statements or W-2s
