**Chemotherapy and drug co-payment assistance grants have specific time deadlines and depending on the Foundation program may only go retro for 30-180 days from your “approved” date, so it is VERY important to apply for these right away. Read through the following and make sure you fully understand how the grants work before applying for any grants, and please feel to ask any me questions in our private facebook group – Breast Cancer Financial Help & Resources -Cancer Butterfly, along the way 🙂
CHEMOTHERAPY DRUGS & OTHER CANCER TREATMENT MEDICATIONS: (The following are all drugs I received as part of my cancer treatment: Evista (hormone blocker), Emend (very expensive anti-nausea drug), Anzemet (chemo drug), Adriamycin (chemo drug), Cytoxan (chemo drug), Taxotere (very expensive chemo drug), Neulasta Injection (to ward off infection, very expensive!).
Actual cost for above chemo/drug expenses: $42,690.19
Contracted amount my insurance paid: $3,489.70
My “out of pocket” cost: $4,402.74
Amount I saved on my “out of pocket” cost: $2,076.17
Amount I actually paid: $2,326.57
The Foundations that offer co-payment assistance have specific rules on how far back they will pay for treatment assistance.
The Foundations use the date that you are actually “approved” for assistance as the starting date. The rules for each foundation vary as far as how many days they will each go retro to cover services that were performed before the date you were approved for assistance.
For example, if you were approved for assistance for the amount of $2,000.00 on say May 1st, and the foundation that approved your grant has a retro rule of only covering services that go retro 90 days, and you needed co-payment assistance with a chemo treatment you received in January, you would not be able to use your awarded grant for the January chemo co-payment.
Now if you needed assistance with a February chemo, you would be able to use your grant funds toward that chemo co-pay because it would be within the 90-day retro rule.
Each foundation will also provide you with a specific end date that you must use your grant benefits by or your benefits will expire and be unusable. Some foundations will allow you to reapply if you get to your benefit expiration date and you still need co-payment assistance.
If you are approved for a co-payment assistance grant the foundation will let you know your approved date, your grant award dollar amount, time period you have to use your co-payment assistance grant, and how many days you will be allowed to use the grant funds for retro services.
The grants are available according to the type of cancer you have (example: breast cancer, colon cancer, thyroid cancer, etc.) and also available according to the type of chemo cancer treatment drugs you are receiving for your treatment.
Each chemo drug usually has a brand name and a generic name. Once it has been decided which chemo drugs you will receive as part of your treatment, you need to be familiar with both the brand name and generic name for each drug.
Chemotherapy may be given with a curative intent (which almost always involves combinations of chemo drugs), so you may be receiving several different chemo drugs at one time that interact well together to combat the cancer cells. So make sure you talk to your doctor and get a complete list of ALL the chemo drugs you are receiving so that you can apply for assistance for each drug you are receiving.
As soon as you know the brand name and generic name of each drug you are receiving for treatment, you should apply for a co-payment assistance grant through whichever foundations that you are eligible to apply to based on the drugs you are receiving and the type of cancer you have (example: breast cancer, colon cancer, thyroid cancer, etc.)
Some foundations only accept a specific number of new applications each month, and some only take new applications during the first few days of each month, so you need to start applying right away, because you may qualify to apply for a certain grant because they are accepting applications for the specific drugs you are receiving and for the specific type of cancer you have (example: breast cancer, colon cancer, thyroid cancer, etc.), however they may tell you that they have already met the limit of applications that they are accepting for those drugs this month, so you would have to wait until the next month. So that is why you want to start calling on the grants right away and make notes on each grant that you call on so that you can call back if necessary the next month.
**BIG TIP: This is a tip that I didn’t fully understand until the grants that I had been approved for almost expired. Let’s say there is a foundation that is accepting new applications for breast cancer patients and they are accepting applications for the specific drugs you are receiving for treatment, however by the time you called they closed that grant for accepting any new applications this month, so they tell you to call back next month on the first day of the month. Normally you would be out of luck for that month and just need to call back the first day of the next month……However, if you are receiving the Neulasta injection (the injection that you get the day after chemo to help fight off infection), you may be able to get your application approved if they are still accepting patients who have CIN (chemo induced anemia). If you are receiving the Neulasta injection you need to specifically ask if they are accepting new applications for the Neulasta injection for patients who have CIN (chemo induced anemia).
If you are able to get your application approved by your having CIN (chemo induced anemia), because you are receiving the Neulasta injection, they will cover your out of pocket insurance co-pay for each neulasta injection as long as it falls during the approved time of your grant or during their preset retro period that may cover treatments received prior to the actual date you were approved.
**HERE IS THE REALLY BIG TIP: If your application was approved for the CIN (chemo induced anemia) , you can usually get your other cancer related co-payments from your other drugs covered as well! As long as the drugs are on the foundations approved drug list (either the brand name or generic name) and your insurance covered a portion of the cost of the drug and it left you with an out of pocket co-pay.
EXAMPLE: Basically let’s say you have breast cancer, but the foundation is not accepting any more new breast cancer applications this month, or they are not accepting any more new applications for the specific drugs you are receiving, you can still apply if they are accepting new applications for CIN (chemo induced anemia). You would qualify to apply as CIN if you are receiving the very expensive neulasta injection. And, because you got your “foot in the door” with your CIN application with this foundation and if approved through your CIN application, you very well may also be able to get ALL your other cancer related drugs covered (as long as they are on that foundations approved list, even if they are not specifically accepting new applications for those drugs any longer that month, and as long as your health insurance paid a portion of the cost, which left you with a co-payment).
This is exactly what happened to me…. I called a specific foundation and asked if they are currently accepting applications for people with breast cancer… they said “yes”. They then asked me which chemo drugs I was receiving for my treatment and I told them:
Taxotere (generic name- Docetaxel)
Adriamycin (generic name- Doxorubicin)
Cytoxan (generic name- cyclophosphamide)
They said they were sorry but, they were closed for accepting new applications for any of those drugs for the month. They let me know that I could call back the first day of next month and apply then. So of course, I was bummed. Then I just happened to be chatting with a gal in the billing department at my oncologist’s office and telling her about my grant situation and then she dropped the GOLD NUGGET…… she said, since I was receiving the Neulasta injection I may be able to apply this month if they are still accepting new applications for the Neulasta injection. And sure enough when I called back and asked if they were accepting new applications this month for people receiving the Neulasta injection they said “yes”. I submitted my application and since I got my “foot in the door” by being able to submit my application through my Neulasta injection, I was also able to use my grant award to cover all my other chemo treatment drugs that were on their approved drug list, which for me covered ALL of mine!
So I received a letter stating:
“We are pleased to inform you that your application for Chemotherapy Induced Anemia/Chemotherapy Induced Neutropenia fund is approved. The Foundation has awarded you $2,500.00 for co-payment assistance for the enrollment period 5/7/2010 to 5/7/2011.”
So, I was able to have the following covered by this grant:
Neulasta Injection: $346.13 (my co-pay out of pocket amount)
Taxotere (generic name- Docetaxel): $694.02 (my co-pay out of pocket amount)
Adriamycin (generic name- Doxorubicin): $8.10 (my co-pay out of pocket amount)
Cytoxan (generic name- cyclophosphamide): $6.08 (my co-pay out of pocket amount)
So, I got reimbursed $1,054.33 !
The only downside to this was……. though I received $1,054.33 to cover my last chemo treatment (I had 6 chemo treatments total), I still had $1,445.67 of available funds to use in my grant. However, since I didn’t find out about these grant programs early enough in my treatment, I applied for the programs after I had actually finished chemo and since the retro rules of this Foundation are that they will only go retro 90-days to cover any treatments that you received before your actual “approved” date, I was not able to use the balance of my available grant funds to cover any of my prior chemo treatments since they fell before the 90-day retro period. So that is why it is so important to apply right away for these programs.
Check out our Foundation Grant list and start making some phone calls!
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Questions on this section??? please feel to ask any me questions in our private facebook group – “Breast Cancer Financial Help & Resources -Cancer Butterfly”
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