| The Leukemia & Lymphoma Society's Co-Pay Assistance Program offers assistance to patients toward: - Private health insurance premiums
- Private insurance co-pay obligations
- Medicare Part B, Medicare Plan D, Medicare Supplementary Health Insurance and Medicare Advantage premium or co-pay obligations
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Prescription drugs covered under this program include those supplied to the patient by a pharmacy or administered in an office or hospital by a health care provider. Prescription insurance coverage is required to qualify for this program. A physician must confirm the patient's diagnosis and that the drugs or physician visits for which they have applied for co-pay or premium assistance are being used to treat a cancer currently covered in the Society's plan. The Co-Pay Assistance program does not cover the following:
• Prescribed devices such as eyeglasses, wheelchairs, pumps, kits, etc.
• Diagnostic procedures such as: PET/CAT/MRI scans, X-rays, etc.
• Laboratory services including blood work, biopsies, cultures, blood draws, bone marrow aspirations, etc.
• Electrocardiogram, Echocardiography (ECG or EKG) Ultrasounds
• Travel expenses, including lodging, meals, parking, tolls, etc.
• Dental and or Vision insurance premiums or expenses
• Fertility and or Reproductive procedures
• Long-term Care Insurance or Cancer Insurance policies
Support for this program is based on the availability of funds by disease diagnosis. Co-Pay Assistance Amounts
Society Co-Pay Assistance funds are currently available up to $5000 for the following diagnoses: You may download, print, complete and send the Co-Pay Assistance Program Application by clicking on one of the links above. Funding Update
The following funds are currently closed. - Acute myelogenous leukemia
- Chronic lymphocytic leukemia
- Hodgkin lymphoma
- Non-Hodgkin lymphoma
- Waldenstrom macroglobulinemia
Please check the Co-Pay webpage regularly for funding updates. We are actively seeking sponsorship for this fund and other blood cancers that are not funded by this program. Call us for assistance if you are uncertain about the coverage of any diagnosis. For more information on financial assistance, please contact the Information Resource Center (800) 955-4572. Income Requirements
Patients whose household income is at or within 500 percent above the U.S. Federal Poverty guidelines are eligible for assistance. Patients who reside in the United States, Puerto Rico and medically and financially qualify may apply. Co-Pay assistance varies according to disease diagnosis. In most cases, the payment will be sent directly to your pharmaceutical supplier, hospital, doctor, insurance provider, and less commonly, directly to a patient. For patients with approved applications needing assistance to complete the Co-Pay Claim Form please refer to the Claim Form Information Guide. The Co-Pay Assistance Program application includes information to be completed and signed by the patient and information to be completed and signed by the patients' physician. Patients will also need to send documentation verifying household income. All documentation will be kept confidential and is viewed solely for approval into the program. The Leukemia & Lymphoma Society
1311 Mamaroneck Ave, Suite 310
White Plains, NY 10605
Attention: IRC - Co-Pay Assistance Program
Fax: (877)-COPAY-FAX or (877) 267-2932 All completed Co-Pay Assistance Program applications will be reviewed within 10-20 business days and applicants will be notified within this time period if anything is missing from their application or of their approval status. Once approved, patients will receive instructions for payment requests. If you have questions about the application process or the Co-Pay Assistance Program, please contact our Co-Pay Assistance Program at (877) 557-2672 or via copay@LLS.org and a specialist will assist you. Patients who participate in the Co-Pay Assistance Program may still apply for the Society's Patient Financial Aid Program for reimbursement of additional treatment related expenses.
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