Disease Based Programs

Disease Based Programs

Program Name HealthWell Foundation
Program Address P.O Box 4133
Gaithersburg, MD 20885-
Phone Number 800-675-8416
Fax Number 800-282-7692

Diseases Acute Porphyrias, Age-Related Macular Degeneration, Anemia associated with Chronic Renal Insuffiency or Chronic Renal Failure, Ankylosing Spondylitis, Asthma, Moderate to Severe Breast Cancer, Carcinoid Tumors and Associated Symptoms, Chemotherapy Induced Anemia/Chemotherapy Induced Neutropenia, Colorectal Carcinoma, Cutaneous T-Cell Lymphoma, Head Cancer, Neck Cancer, Hodgkin's Disease, Immunosuppressive Treatment for Solid Organ Transplant Recipients, Iron Overload as a Result of Blood Transfusions, Multiple Myeloma, Myelodysplastic Syndromes, Non-Hodgkin's Lymphoma, Non-Small Cell Lung Cancer, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Secondary Hyperparathyroidism, Wilms' Tumor

Details This program helps pay for medical expenses including: medications, copayments, insurance premiums and other out-of-pocket healthcare costs. If accepted into the program, the patient is covered for up to one year. Accepted patients must submit invoices or receipts to reveice monetary awards. The foundation typically sends awards directly to the insurer, pharmacy, physician, or other provider. However, in some cases it may send awards directly to patients to reimburse them for expenses they must pay themselves.
Eligibility Guidelines Individuals covered by private insurance, employer-sponsored plans, Medicare or Medicaid may be eligible. The families income must be at or below 400% of the Federal Poverty Level, and state cost of living is also taken into account.
How To Apply Call the above number to get an application or apply on line.

Advanced Renal Cell Carcinoma
NORD Advanced Renal Cell Carcinoma Co-Payment Assistance Program
Program Address 55 Kenosia Ave
Danbury, CT 06813
Phone Number 866-828-8902
203-744-0100
Fax Number 203-798-2291

Diseases Advanced Renal Cell Carcinoma

Details This program will provide financial assistance to cover the costs of co-pays for approved medications used to treat Advanced Renal Cell Carcinoma. Contact the program directly or visit the program website for a list of approved medications.
Eligibility Guidelines Uninsured or underinsured individuals living with Advanced Renal Cell Carcinoma.
How To Apply Contact the program directly to apply for assistance.
Area of Service National

Age-Related Macular Degeneration
Program Name Chronic Disease Fund
Program Address 10880 John W. Elliott Drive, Suite 400
Frisco, TX 75034
Phone Number 877-968-7233
972-712-0201
Fax Number 214-975-1114

Diseases Age Related Macular Degeneration, Ankylosing Spondylitis, Asthma, Breast Cancer, Colorectal Cancer, Growth Hormone Deficiency, Multiple Myeloma, Multiple Sclerosis, Myelodysplastic Syndrome, Non-Small Cell Lung Cancer, Psoriasis, Pulmonary Arterial Hypertension, Rheumatoid Arthritis.

Details This program provides financial assistance to insured patients by covering the out-of-pocket expenses associated with prescription drug plans.
Eligibility Guidelines The applicant must meet eligibility requirements, including treatment of a covered disease state, insurance documentation and proof of income.
How To Apply The application can be downloaded from the website, or by calling the above toll-free number. The completed application must include proof of income, a copy of each insurance card, and a signed HIPAA Authorization.
Area of Service National

Program Name Patient Access Network Foundation
Program Address P.O. Box 221858
Charlotte, NC 28222-
Phone Number 866-316-7263
Fax Number 866-316-7261

Diseases Age Related Macular Degeneration, Anemia, Ankylosing Spondylitis, Breast Cancer, Colorectal Cancer, Crohn's Disease, Cutaneous T-Cell Lymphoma, Cystic Fibrosis, Gaucher's Disease, Growth Hormone Deficiency, Multiple Myeloma, Multiple Sclerosis, Myelodysplastic Syndrome, Non-Hodgkin's Lymphoma, Oncology Cytoprotection, Pancreatic Cancer, Plaque Psoriasis, Rheumatoid Arthritis , Respiratory Syncytial Virus

Details This program helps pay for medical expenses including: medications, co-payments, insurance premiums and other out of pocket health care costs.
Each disease has it's own application.
Eligibility Guidelines Individuals must be U.S. residents and meet certain financial, medical and insurance criteria as set by the Foundation's board of directors.
How To Apply Call the above number to get an application or apply on line.
Area of Service Nationwide

Alopecia Areata

Program Name Locks Of Love
Program Address 2925 10th Avenue N
Suite 102
Lake Worth, FL 33461
Phone Number 561-963-1677
888-896-1588
Fax Number 561-963-9914

Diseases Serious Childhood Disease, Childhood Cancer, Alopecia Areata, Hair Loss

Details This program provides high quality hair prosthetics to financially disadvantaged children in the United States and Canada who are under age 18 and living with long-term medical hair loss from any diagnosis. The retail value of the hair prosthetics is generally between $3,500 to $6,000. This program will also provide synthetic hairpieces to children living with short term hair loss.
Eligibility Guidelines Must be a resident of the United States or Canada, under age 18, living with long-term medical hair loss and meet financial eligibility guidelines as determined by the program.
How To Apply Contact the program directly, or visit the program website and complete an application.
Area of Service National

Program Name National Alopecia Areata Foundation Ascot Fund
Program Address 14 Mitchell Boulevard
San Rafael, CA
Phone Number 415-472-3780
Fax Number 415-472-5343

Diseases Alopecia Areata

Details This program provides hairpieces to children who are living with Alopecia Areata
Eligibility Guidelines Must be a family of a child living with Alopecia Areata
How To Apply Please email (laura@naaf.org) to receive an Ascot Fund Application.
Area of Service National

Alpha-1-Antitrypsin Deficiency

Program Name Alpha-1 Kids
Program Address 4600 Keswick Road
Baltimore, MD 21210
Phone Number 410-227-9524

Diseases Alpha-1-antitrypsin deficiency
Details This program provides a financial grant in the amount of $2500 to transplant patients and their families to help pay for the cost of food, bills, housing, travel expenses and any other need to help make the process, usually away from home, easier on the families.
Eligibility Guidelines Liver transplant patients and their families.
How To Apply Contact the program directly to apply, or visit the program website for more information.
Area of Service National

Chronic and Serious illnesses

Program Name Patient Services, Inc.
Program Address PO Box 1602
Midlothian, VA 23113
Phone Number 800-366-7741
Fax Number 804-744-5407
Diseases Alpha-1-Antitrypsin Deficiency, Bone Health, Chronic Myelocytic Leukemia, Gastrointestinal Stromal Tumors, IGF-1 (Insulin-like Growth Factor Deficiency), Hemophilia, MPS-1 Hurler/Scheie, Primary Immune Deficiency, Fabry Disease, Pompe, Severe Congenital Protein C Deficiency, Cystic Fibrosis associated with Pseudomonas Aeruginosa, Cutaneous T-Cell Lymphoma, Asthma (Moderate to Severe IgE-mediated Asthma)
Details This program assists persons with chronic medical illnesses in accessing health insurance and pharmacy co-payment assistance.
Eligibility Guidelines The patient must have insurance and be a US citizen.
How To Apply Call the above number to get more information and request an application.
Area of Service Nationwide

Name Caring Voice Coalition
Program Address 8249 Meadowbridge Road
Mechanicsville, VA 23116
Phone Number 888-267-1440
804-427-6468
Diseases Chronic, Serious illnesses
Details There are three categories to the program. The Medicare Prescription Drug Assistance Program will help clients pay for medication while the client is in the Medicare Part D coverage gap. The Insurance Copayment Assistance program will help in paying copayments or coinsurance costs to the pharmacy.The Insurance Premium Assistance Program helps clients pay for insurance premiums.
Eligibility Guidelines The applicant must have a chronic illness supported by CVC, be taking an FDA approved drug for the treatment and have current health insurance that covers the medication. The applicant must also show a need for financial help.
How To Apply Call the program to request an application, or visit the program website for more information.
Area of Service National

Childhood Liver Disease

Program Name CLASS Direct Family Support
Program Address 27023 McBean Parkway #126
Valencia, CA 91355
Phone Number 877-679-8256
661-263-9099
Diseases Childhood Liver Disease
Details This program covers travel expenses for services related to liver ailment, telephone installation and service charges while waiting for a transplant, travel expenses to reunite families during extended hospital services, temporary housing for out-of-town patients who are released from the hospital but need frequent monitoring, hospital parking fees, assistance with funeral and burial expenses, food allowance while staying with a hospitalized patient, and gas allowance to allow family to visit the hospitals.
Eligibility Guidelines The patient must be between the ages of 0 and 21 and have be suffering from liver disease. This program is intended as a source of funds after all other avenues have been exhausted. The maximum lifetime assistance per family is $750 (excluding funeral and burial expenses.) The maximum of $500 is given for funeral and burial expenses. A maximum of $20 per family per day.
How To Apply A request for assistance must come through a social worker, or other appropiate person at the hospital, clinic or medical institution who has access to the family's financial situation.
Area of Service Nationwide

Transplants

Program Name Nielsen Organ Transplant Foundation
Program Address 580 West 80Th St
Suite 8000
Jacksonville, FL 32209
Phone Number 904-244-9823
Diseases Organ Transplant
Details The Foundation assists with transplant-related expenses such as medication, medical and dental bills, and housing and transportation costs.
Eligibility Guidelines In order to be considered for financial assistance the applicant must submit a completed application, a statement from his/her transplant center confirming his/her patient status, and complete bills or statements for the request.
How To Apply Call the above number or go the website to get more information and/or an application.
Area of Service North East Florida.

Program Name Tiger Fund Transplant Family Aid Program
Program Address 21218 St Andrews Blvd #641
Boca Raton, FL 33433
Diseases Organ Transplant, Tissue Transplant
Details Direct financial assistance to needy organ transplant families with the purchase of necessary equipment, supplies and medicines. This program is generally for "one-time" expenses. The foundation coordinates with regional Organ Procurement Organizations to help prioritize the neediest cases. At the present time, special consideration is given to the following cases: Liver transplant patients and families in the following areas: Southeastern Florida, Denver, CO metro area, Sacramento, CA metro area.
Pediatric liver patients and families. Liver patients with end stage liver disease.
Eligibility Guidelines The applicant must be an organ/tissue candidate, recipient, donor or immediate family member and have financial need.
How To Apply The application can be downloaded from the website. Letter recommendations and an explanation of financial need must be attached to the application.
Area of Service National

Patient Advocate Foundation

Program Name Patient Advocate Foundation
Program Address 700 Thimble Shoals Blvd
Suite 200
Newport, VA 23606
Phone Number 800-532-5274
Fax Number 757-873-8999
Email help@patientadvocate.org
Diseases Chronic, Debilitating or Life Threatening Disease
Details This program will help with every aspect of financial struggles due to illness. They will work with insurance, doctors, and hospitals to find assistance in paying for needed care. They will also help find ways to pay for any medical debt and/or cost of living issues brought on by the disease.
Eligibility Guidelines The patient must have a chronic, debilitating or life threatening disease.
How To Apply Call the above number to start the process.
Area of Service Nationwide

Respiratory Disease

Program Name Respiratory Disease Wellcare Program
Program Address 4812 S. Mill Ave
Tempe, AZ 85282
Phone Number 480-967-9203
800-307-8048
Fax Number 800-345-2425
Diseases Asthma, Chronic Bronchitis, COPD, Emphysema, Lung Cancer
Details This program will provide home delivery of medications, respiratory therapy and assistance with paperwork for Medicare and other insurers.
Eligibility Guidelines The applicant must be a US resident, Medicare enrolled or eligible and suffer from a chronic lung disease.
How To Apply Call the program or apply on line.
Area of Service National

Surgeries

Program Name Surgery on Sunday, Inc (SOS)
Program Address PO Box 498
Lexington, KY 40504
Phone Number 859-246-0046
Fax Number 859-246-1752
Diseases In need of surgery for illness or condition
Details This program helps people who are need of surgeries but can't afford them, who live in Kentucky. This is a referral based program, that works with clinics to give free surgeries and treatments to accepted applicants on Sunday a month.
Eligibility Guidelines The applicant must not qualify for Medicare or Medicaid and not afford health insurance.
How To Apply All applicants must be referred to the program by a participating organization. There is a list on the website of these organizations, or call the program to get more information.
Area of Service Kentucky

Alzheimers

Program Name Faith In Action
Program Address Wake Forest University School of Medicine
Medical Center Boulevard
Winston-Salem, NC 27157
Phone Number 877-324-8411
336-716-0101
Fax Number 336-777-3284
Diseases Mental Illness, Terminal Illness, Physical Disability, Mental Disability, HIV/AIDS, Alzheimers and Dementia.
Details This national program provides links to local programs that can provide transportation, respite care relief and other support services. Each local chapter (many states have more than one) provides different help to different populations of people. Diseases or conditions include mental illness, terminal illness, physical disability, mental disability, HIV/AIDS, Alzheimers and dementia.
Eligibility Guidelines Contact the program directly for information on eligibility details.
How To Apply Contact the program directly to apply for assistance.
Area of Service National

Amputation

Program Name Challenged Athletes Foundation (Access For Athletes)
Program Address 11199 Sorrento Valley Rd., Suite C
San Diego, CA 92121
Phone Number 858-866-0959
Fax Number 858-866-0958
Diseases Including, but not limited to: Amputee, Cerebral Palsy, Visual Impairment, Spinal Cord Injuries, Intellectual Disability.
Details This program provides funding for prosthetics, training, competition and adaptive sports equipment such as sports wheelchairs, handcycles, and mono skis.
Eligibility Guidelines To be eligible for a grant through this program, an athleteâ€™s disability must be recognized within the International Paralympic Committee (IPC) classifications. Disabilities include, but are not limited to, amputee, Cerebral Palsy, visual imparement, spinal cord injuries and intellectual disability.
How To Apply A Grant Cover Letter and Grant Application may be downloaded from the program website and submitted to the program for consideration.
Area of Service National

Program Name Limbs for Life Foundation
Program Address 5929 N. May
Suite 511
Oklahoma City, OK 73112
Phone Number 888-235-5462
405-843-5174
Fax Number 405-843-5123
Email admin@limbsforlife.org
Diseases Amputation
Details This foundation that has program that will provide financial assistance to help pay for a prosthesis.
Eligibility Guidelines The applicant must be a legal resident of the US and not have a felony (if a misdemeanor, it is taken in front of the board for review)
How To Apply Download the application from the program website. The completed application will then be taken to the board for review.
Area of Service National

Program Name The Limb Preservation Foundation
Program Address 1600 Broadway Street, Suite 2400
Denver, CO 80202
Phone Number 303-429-0688
303-217-0998
Fax Number 970-532-1077
Diseases Amputation
Details The Patient Assistance Grant Fund is focused on assisting extremity patients with needed medical treatments and/or recovery services including outpatient intravenous antibiotics, outpatient physical therapy and outpatient occupational therapy. The Medical Transport Fund has been designed to assist extremity patients who are in need of travel assistance to a specialized medical facility for evaluation, diagnosis, and/or treatment and for whom travel would otherwise be financially prohibitive. The Emergency Distress Fund provides "last resort" financial support to qualifying extremity patients. It is designed to solve a problem which threatens the immediate health, safety or self-sufficiency of a extremity patient or their family by preventing the loss of adequate shelter, eviction of possessions and additional medical care.
Eligibility Guidelines Applicants must be extremity patients with needed medical treatments and/or recovery services who live in the Rocky Mountain region and meet the financial criteria of the prpogram.
How To Apply Download an application from the program website, or contact the program directly. All applications must be submitted by a healthcare professional and/or case manager. Once an application is submitted, the Grant Review Committee will review the information and will determine if funding will be provided based on the specifics of the individual case, the patient's financial need and the availability of funds.
Area of Service Rocky Mountain Region

Amyotrophic Lateral Sclerosis

Program Name ALS Association Jim
Program Address 120-101 Penmarc Drive
Raleigh, NC 27603
Phone Number 877-568-4347
Diseases Amyotrophic Lateral Sclerosis
Details This association has two grants programs to assist people in North or South Carolina with ALS. The Respite Care Grant Program provides funds for respite services. Grants will be awarded in the amount of $500 each, with a limit of $2000. The Transportation Grant Program assists patients and caregivers with transportation services. The grant is awarded in the amount of $250, with a limit $1000.
Eligibility Guidelines Both programs are based on need.
How To Apply Applications are available on line.
Area of Service South Carolina

Program Name ALS Association Massachusetts Chapter
Program Address 75 McNeil Way
#130
Dedham, MA 02026
Phone Number 800-258-3323
781-326-8884
Diseases Amyotrophic Lateral Sclerosis
Details This association has two programs to assist patients with ALS and their families. The Paul Tamburello Respite Care Program can provide funding for short-term respite care, including home health care (nurses and aides), a short stay in a nursing home or rehabilitation hospital or an adult day health program. The Children's Program can provide assistance for ALS patients with children. This fund will cover such programs as community programs, summer camp and mental health counseling.
Eligibility Guidelines Priority for both programs are given to those with the greatest need. For the Children's Program the children must be under the age of 18.
How To Apply Contact the application for information and to apply.
Area of Service Massachusetts

Program Name University of Miami Kessenich Family MDA ALS Center
Program Address The ALS Recovery Foundation Patient Care Fund C/o Kessenich Family MDA ALS Center
1150 NW 14th St, Suite 700
Miami, FL 33136
Phone Number 800-690-2571
305-243-7400
Email ggonzal4@med.miami.edu
Diseases Amyotrophic Lateral Sclerosis
Details The Patient Care Fund Grant provides aid to families impacted by ALS by providing financial assistance to those in need of equipment and/or supplies.
Eligibility Guidelines The applicant must be in need.
How To Apply The application can be downloaded from the website. Applicants must also enclose proof of income, an Explanation of Benefit and a written estimate for the cost of the needed equipment.
Area of Service Florida counties of Dade, Broward, Monroe and Palm Beach County.

Anemia Chemotherapy Induced

Program Name HealthWell Foundation
Program Address P.O Box 4133
Gaithersburg, MD 20885-
Phone Number 800-675-8416
Fax Number 800-282-7692
Diseases Acute Porphyrias, Age-Related Macular Degeneration, Anemia associated with Chronic Renal Insuffiency or Chronic Renal Failure, Ankylosing Spondylitis, Asthma, Moderate to Severe Breast Cancer, Carcinoid Tumors and Associated Symptoms, Chemotherapy Induced Anemia/Chemotherapy Induced Neutropenia, Colorectal Carcinoma, Cutaneous T-Cell Lymphoma, Head Cancer, Neck Cancer, Hodgkin's Disease, Immunosuppressive Treatment for Solid Organ Transplant Recipients, Iron Overload as a Result of Blood Transfusions, Multiple Myeloma, Myelodysplastic Syndromes, Non-Hodgkin's Lymphoma, Non-Small Cell Lung Cancer, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Secondary Hyperparathyroidism, Wilms' Tumor
Details This program helps pay for medical expenses including: medications, copayments, insurance premiums and other out-of-pocket healthcare costs. If accepted into the program, the patient is covered for up to one year. Accepted patients must submit invoices or receipts to reveice monetary awards. The foundation typically sends awards directly to the insurer, pharmacy, physician, or other provider. However, in some cases it may send awards directly to patients to reimburse them for expenses they must pay themselves.
Eligibility Guidelines Individuals covered by private insurance, employer-sponsored plans, Medicare or Medicaid may be eligible.The families income must be at or below 400% of the Federal Poverty Level, and state cost of living is also taken into account.
How To Apply Call the above number to get an application or apply on line.
Area of Service National

Asthma

Program Name Austism Family Resources
Program Address PO Box 595
Victor, MT 59875
Diseases Autism
Details This program provides funding for therapy equipment, safety equipment, or respite care to families with children who have Autism or other special needs. The program will provide a one time grant for up to $500. The money will be sent directly to the vender or service provider.
Eligibility Guidelines The applicant must have a family income that does not exceed $50,000 a year, and have a child with Autism or Special Needs.
How To Apply To apply email a request for an application along with name, phone, address and email address to the program. The application will then be emailed back.
Area of Service National

Program Name Autism Society of America-Hudson Valley New York Chapter
Program Address 18 Jansen Road
Stone Ridge, NY 1284
Phone Number 845-338-0419
Diseases Autism
Details This local chapter has an emergancy fund to help families or care givers of a person with Autism Spectrum Disorder. The assistance can be up to $200 to help pay for bills, buy specialized equipment, or to pay for necessary medical treatment. This is a one time assistance program.
Eligibility Guidelines The applicant must be a parent or caregiver of a person with Autism Spectrum Disorder living in the Hudson Valley and must have exhausted all of avenues of financial assistance.
How To Apply The application can be filled out on the website or call the program for more information.
Area of Service New York, Hudson Valley Counties.

Program Name Children' Special Health Care Services -Indiana State Department of Health
Program Address Indiana State Department of Health
2 north Meridian St
Indianapolis, In 46204
Phone Number 800-475-1355
317-233-1325
Diseases Childhood chronic, critcal conditions. (Can include apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias, chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.)
Details This is a supplemental program that helps Indiana families of children with serious, chronic medical conditions pay for treatment to treatment related to their child's condition.
Eligibility Guidelines The child must be aged newborn to 21 years old, a resident of Indiana and have an income at or below 250% of the Federal Poverty Level. The child must also have a severe medical conditions that have lasted (or are expected to last) at least two years, will produce disability or disfigurement or limits on function, require special diet or devices, or, would produce a chronic disabling physical condition if untreated. Some physical conditions that may qualify a child for services include: apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.
How To Apply Contact the local county Office of Family and Children, the local First Steps agencey or Riley Hospital. To complete an application the applicant will need the chld's birth certificate, proof of residence, social security number of the child, and proof of parent(s)/guardian(s) income.
Area of Service Indiana

Program Name National Autism Association Helping Hand Program
Program Address 210 Copley Street
Crystal Springs, MS 39059
Phone Number 877-622-2884
Diseases Autism
Details This is a program of last resort to help parents of children under the age of 18 with autism spectrum disorder to pay for necessary biomedical treatments, supplements and therapy services. The maximum amount given per family is a one time grant of $1,500.
Eligibility Guidelines The patient must be at or under the age of 18, reside in the US and have been dianosed with an autism spectrum disorder.
How To Apply The application can be downloaded from the website. A letter from the child's doctor must be sent back with the completed applicaiton. If the request exceeds $300, a copy of the most recent tax form must be attached as well.
Area of Service National

Program Name Wyoming Children's Special Health
Program Address 6101 N Yellowstone Rd.
Suite 420
Cheyenne, WY 82002
Phone Number 307-777-5413
307-777-7941
Fax Number 307-777-7215
Diseases Convulsive Disorders, Neurofibromatosis, Juvenile Idiopathis Arthritis, Cystic Fibrosis, Diabetes Mellitus Type I, Esotropia, Exotropia and Amblyopia, Autism Spectrum Disorder/Pervasive Developmental Delay, Global Developmental Delay, Osteogenesis Imperfecta, Retinopathy of Prematurity, Tympanostomy Tubes, Hemophilia and Variants, Cerebral Palsy
Details This is a program that provides financial assistance to families with children who have special health care needs in Wyoming. The program will pay for specialty medical care related to the approved/condition/diagnosis. There is up to $40,000 maxium annual coverage.
Eligibility Guidelines The child must be a Wyoming resident under the age of 19 and be suspected or known to have one of the medically eligibles (ie chronic illness or disability) The child can have insurance, KidCare, CHIP, Medicaid.
How To Apply To apply or get more information contact The Public Health Nurse (a list is available on the website.) The child's medical, education and family financial records are required when meeting with the Public Health Nurse.
Area of Service Wyoming

Birth Defects in Children

Program Name Fresh Start
Program Address 2011 Palomar Airport Rd
Suite 206
Carlsbad, CA 92011
Phone Number 760-944-7774
866-551-1729
Fax Number 760-944-1729
Diseases Childhood physical deformities caused by birth defects, accidents, abuse or disease
Details This foundation provides no cost surgery, dental care and speech therapy to children who are suffering for physical deformities caused by birth defects, accidents, abuse or disease. The foundation also provides transportation assistance so patients can get to the surgery site in San Diego. The surgeries take place on certain weekends (see the website for more details.)
Eligibility Guidelines The patient must be a child from 1 to 21 years old who is suffering from physical deformities caused by birth defects, accidents, abuse or disease and be financially disadvantaged.
How To Apply Call the foundation for more information or download the application from the website.
Area of Service National

Bleeding Conditions

Program Address State of California Department of Health Services
PO Box 942732
Sacramento, CA 94234
Phone Number 800-639-0597
916-327-0470
Diseases Von Hippel Lindau Disease, Selected herditary metabolic disorders including Phenylketonuria, Huntington's Diease, Fredreich's Ataxia, Joseph's Disease, Sickle Cell Disease, Thalassemia, Cystic Fibrosis, Hemophilia and certain other hereditary bleeding conditions.
Details This program coordinates care and helps pay for medical costs for eligible applicants. The services covered include Special Care Center services, hospital inpatient and outpatient services including x-rays, laboratory and other diagnostic services, physican/dental services, prescription medications, food supplements, blood products, oxygen, medical supplies, physical, occupational and speech therapy, psychosocial services, prosthetic and orhopedic applicances, durable medical goods, certain home health agency services, and emergancy services.
Eligibility Guidelines The applicant must have one of the listed diseases, be a resident of California and complete an application. Applicants may be required to apply to Medi-Cal. There is no income eligibilty requirements, but applicants with an income greater than 200% of the Federal Poverty Level may have to pay an enrollment fee and treatment costs based on a sliding scale fee.
How To Apply Call or write the program to apply.
Area of Service California

Program Address 8800 Roswell Road
Suite 170
Atlanta, GA 30350,
Phone Number 770-518-8272
Email mail@hog.org
Diseases Hemophilia Bleeding Disorders Clotting von Willebrand Disease
Details This program provides financial assistance with health insurance costs, clinic charges, infusion supplies, factor and clotting medications, Medic Alert bracelets and other expenses to residents of Georgia who are living with Hemophilia and other bleeding disorders.
Eligibility Guidelines Resident of Georgia diagnosed with Hemophilia, von Willebrand Disease or other bleeding disorders.
How To Apply Contact the program by phone or email.
Area of Service Georgia

Program Name Genetically Handicapped Persons Program
Program Address State of California Department of Health Services
PO Box 942732
Sacramento, CA 94234
Phone Number 800-639-0597
916-327-0470
Diseases Von Hippel Lindau Disease, Selected herditary metabolic disorders including Phenylketonuria, Huntington's Diease, Fredreich's Ataxia, Joseph's Disease, Sickle Cell Disease, Thalassemia, Cystic Fibrosis, Hemophilia and certain other hereditary bleeding conditions.
Details This program coordinates care and helps pay for medical costs for eligible applicants. The services covered include Special Care Center services, hospital inpatient and outpatient services including x-rays, laboratory and other diagnostic services, physican/dental services, prescription medications, food supplements, blood products, oxygen, medical supplies, physical, occupational and speech therapy, psychosocial services, prosthetic and orhopedic applicances, durable medical goods, certain home health agency services, and emergancy services.
Eligibility Guidelines The applicant must have one of the listed diseases, be a resident of California and complete an application. Applicants may be required to apply to Medi-Cal. There is no income eligibilty requirements, but applicants with an income greater than 200% of the Federal Poverty Level may have to pay an enrollment fee and treatment costs based on a sliding scale fee.
How To Apply Call or write the program to apply.
Area of Service California

Program Name Great Lakes Hemophilia Foundation
Program Address 638 N 18th St
Suite 108
Milwaukee, WI 53201
Phone Number 414-257-0200
888-787-4543
Fax Number 414-257-1225
Diseases Hemophilia, von Willebrand Disease, or other Bleeding Disorders
Details This program will assist residents of Wisconsin medical bills, insurance premiums or basic living needs. There are grants for uncovered insurance premiums, uncovered medical bills and basic living needs, and loans for medical services that will later be reimbursed by insurance.
Eligibility Guidelines The applicant must be a Wisconsin resident registered with GLHF, have a diagnosis of hemophilia, von Willebrand disease, other bleeding disorder served by GLHF or HIV resulting from a relationship with an individual with hemophilia.
How To Apply Contact David Linney at 414-257-0200
Area of Service Wisconsin

Program Name Hemophilia Association of Arizona Emergency Assistance
Program Address 4001 North 24th Street
Phoenix, AZ 85016
Phone Number 602-955-3947
888-754-7017
Fax Number 602-955-1962
Diseases All bleeding and clotting diseases
Details This is a program of limited assistance to help families pay for an electric, water or phone bill.
Eligibility Guidelines Unclear at this time.
How To Apply Contact the association for more information.
Area of Service Arizona

Program Name Hemophilia Foundation of Michigan Emergency Financial Assistance Program
Program Address 1921 West Michigan Ave
Ypsilanti, MI 48197
Phone Number 734-544-0015
800-482-3041
Fax Number 734-544-0095
Diseases Hemophilia, Bleeding Disorders
Details This is an emergency program to assist with items such as food, utility bills, rent and car repairs for individuals whose bleeding disorder impacts their income.
Eligibility Guidelines Assistance is dependant on serverity of the need, ability of applicant to change her/his financial standing, status of the Financial Aid Fund, and the applicant must not have recieved financial aid from HFM in the past twelve months.
How To Apply Call the program for more information.
Area of Service Michigan

Program Name Hemophilia of Georgia
Program Address 8800 Roswell Road
Suite 170
Atlanta, GA 30350,
Phone Number 770-518-8272
Email mail@hog.org
Diseases Hemophilia Bleeding Disorders Clotting von Willebrand Disease
Details This program provides financial assistance with health insurance costs, clinic charges, infusion supplies, factor and clotting medications, Medic Alert bracelets and other expenses to residents of Georgia who are living with Hemophilia and other bleeding disorders.
Eligibility Guidelines Resident of Georgia diagnosed with Hemophilia, von Willebrand Disease or other bleeding disorders.
How To Apply Contact the program by phone or email.
Area of Service Georgia

Program Name Hemophilia of Indiana
Program Address 5170 E.65th Street
Indianapolis, IN 46220
Phone Number 317-570-0039
800-241-2873
Fax Number 317-570-0058
Diseases Hemophilia, Bleeding Disorders, Clotting Disorder
Details This program will help members with assistance for quality of life issues, such as food, clothing and shelter as well as uncovered medical expenses
Eligibility Guidelines Contact the program for details.
How To Apply Call the above numbers.
Area of Service Indiana

Program Name Hemophilia Society of Colorado
Program Address 655 Broadway, Suite 575
Denver, CO 80203
Phone Number 303-629-6990
888-687-CLOT
Fax Number 303-629-7035
Diseases Hemophilia, Bleeding Disorders, Clotting Disorder
Details This program has two components, one for members of the society who have HIV and those who do not. The program will help with one-time emergencies such as food, utility bills, special shoes etc.
Eligibility Guidelines The applicant must be a paid current member or lifetime member.
How To Apply Call the above number or go to the website to get an application.
Area of Service Colorado

Program Name Kentucky Cabinet for Health and Family Services Hemophilia Program
Program Address 275 East Main Street
Frankfort, KY. 40621,
Phone Number 800-372-2973
Diseases Hemophilia Bleeding Disorder
Details This program provides ongoing care to children and adults with Hemophilia. The program provides financial assistance for factor and medications needed to control bleeding in the case of lost medical benefits. In Lexington or Eastern Kentucky call (800) 333-7359 or (859)-257-6033, inLouisville or Western Kentucky call (800) 232-1160 or (502) 595-4459.
Eligibility Guidelines Eligibility for patients with Hemophilia, regardless of age, is determined by financial status, family size, outstanding medical expenses and the severity of the disease.
How To Apply Contact the program.
Area of Service Kentucky

Program Name Children's Cancer Center Financial Assistance
Program Address 4901 West Cypress Street
Tampa, FL 33607
Phone Number 813-367-5437
Fax Number 813-367-3865
Diseases Children with Cancer, Blood Disorders, Sickle Cell Anemia
Details This program assists families of children with cancer or blood disorders in the Tampa Bay or Boca Raton area with direct financial assistance. This assistance can include: Medications not covered by Insurance, CMS or Medicaid, Travel Expenses to and from the hospitals for families who live outside of the area, Food and Lodging for bone marrow transplant patients, Mortgage/Rent and Utility Payments, Funeral Expenses, Car Repair Expenses/Payments, Assistance with Groceries and additional needs as determined by pediatric staff.
Eligibility Guidelines The applicant must be a family with a child who has been diagnosed with cancer or a blood disorder who is in need.
How To Apply Patients should be referred to the foundation by social worker at the hospital.
Area of Service The Tampa Bay and Boca Raton areas.

Bone Disorders & Bone Marrow Disorders

Program Name National Marrow Donor Program Search Assistance
Program Address Suite 500
3001 Broadway St Ne
Minneapolis, MN 55413
Phone Number 800-627-7692
888-999-6743
Diseases Bone Marrow Transplant
Details This program provides assistance to patients searching the NMDP registry for a possible donor. The money goes directly the to the patient’s transplant center to begin the search process.
Eligibility Guidelines The patient must be a US resident and be unable to afford the costs un-assisted. The treatment plan must include an unrelated donor transplant. The treatment center must be an NMDP transplant center that has already started a preliminary search for a donor on the NMDP.
How To Apply Call the above number for more information. The transplant center coordinator must submit the application the the NMDP.
Area of Service Nationwide.

Program Name National Marrow Donor Transplant Assistance
Program Address Suite 500
3001 Broadway St Ne
Minneapolis, MN 55413
Phone Number 800-627-7692
888-999-6743
Diseases Bone Marrow Transplant
Details This program will help pay for some costs during the first six months after the transplant that are not covered by insurance. These funds can help with temporary housing, food for patient or caregiver(s), parking or mileage, insurance premiums, and/or post transplant prescriptives that are uncovered, clinic visits, and co-pays.
Eligibility Guidelines The patient must be a US resident, be unable to afford the costs unassisted and be within 6 months of the the transplant. An unrelated donor was found through the NMDP The treatment plan must include an unrelated donor transplant. The treatment center must be an NMDP transplant center that has already started a preliminary search for a donor on the NMDP.
How To Apply Call the above number for more information. The transplant center coordinator must submit the application the the NMDP.
Area of Service Nationwide

Program Address 337 East 88th Street
Suite 1B
New York, NY 10128,
Phone Number 212-838-3029
800-365-1336
Diseases Any form of Cancer
Details The Patient Aid Program covers the cost for donor searches, compatibility testing, bone marrow procurement, medication, transportation, housing expenses and many other ancillary costs associated with a transplant. This program is currently the only organization providing direct patient assistance not limited by disease, age or type of transplant. The Patient Aid Program is available at hospitals nationwide.
Eligibility Guidelines You must be a transplant patient who is a resident of the United States.
How To Apply The application for Patient Aid Program requires information about diagnosis, treatment, financial status and information from your social worker and physician. If you are interested in applying for a Patient Aid Program grant, please contact your social worker or transplant coordinator. If you would like further information please contact us at 1-800-365-1336.
Area of Service United States

Bone and Joint Deformaties

Program Name Shriners Hospitals for Children
Program Address PO Box 31356
Tampa, FL 33621
Phone Number 800-237-5055
Diseases Orthopedic Conditions, Burn Injuries, Spinal Cord Rehabilitation, Cleft Lip, Palate Repair.
Details Shriners Hospitals for Children are located throughout the United States and the hopsitals provided free care to children whom have a reasonable possibility that the child's condition can be helped by the the hospital.
Eligibility Guidelines The child must be under the age of 18. There are not any income limits.
How To Apply Call the program or go to the website to get an application.
Area of Service National

Brain Injury

Program Name Traumatic Brain Injury (TBI) Fund
Program Address 222 South Warren Street
PO Box 700
Trenton, NJ 08625
Phone Number 609-292-7800
Fax Number 609-292-1233
Email Edmund.Armah@dhs.state.nj.us
Diseases Traumatic Brain Injury
Details The purpose of the Traumatic Brain Injury (TBI) Fund is to allow New Jersey residents who have survived an acquired brain injury to obtain the services and supports they need to live in the community. The Fund pays for supports and services that foster independence and maximize quality of life. Individuals may be eligible for up to $15,000 per year in supports and services, with a lifetime cap of $100,000.
Eligibility Guidelines Fund recipients must provide medical documentation of acquired brain injury, have liquid assets of less that $100,000 and be a resident of New Jersey for at least 90 consecutive days.
How To Apply To obtain an application, please call the program at 888-285-3036 (press 2). After your completed application and medical documentation are received, you will receive a case manager who will assist you in determining your needs. Your case manager will complete a support plan, which will be reviewed by the TBI Fund staff and then by the Review Committee. You will then receive a letter informing you of the decision.
Area of Service New Jersey

Brain Tumor Disorders

Program Name Brain Tumor Foundation for Children, Inc
Program Address 6065 Roswell Rd, NE
Suite 505
Atlanta, Ga 30328
Phone Number 404-252-4107
Fax Number 404-252-4108
Diseases Children with Brain Tumors
Web Site No link available.
Details This foundation has the Butterfly Fund that will provide direct financial assistance to qualfied families who are receiving treatment at specific hospitals.
Children's Healthcare of Atlanta; the Medical College of Georgia in Augusta, Georgia; the Medical Center of Central Georgia in Macon, Georgia; Backus Children's Hospital of Memorial Health University Medical Center in Savannah, Georgia; Columbus Medical Center in Columbus, Georgia; Shands Children's Hospital at the University of Florida in Gainesville; and Vanderbilt Children’s Hospital in Nashville, Tennessee
Eligibility Guidelines The applicant must be a child with a brain tumor who is receiving care at one of the above listed hospitals.
How To Apply Contact the foundation or speak with a hospital social worker for more information.
Area of Service Specific Hospitals in Georgia

Program Name Brain Tumor Society Cares Financial Assistance Program
Program Address 124 Watertown Street, Suite 3H
Watertown, MA 02472
Phone Number 800-770-8287
617-924-9997
Fax Number 617-924-9998
Diseases Brain Tumors
Details This foundation will help people with brain tumors pay for non medical expenses such as transportation, home health assistance, home adaptations and child care relating to the brian tumor diagnosis. The grant can be up to $2,000 per year. The society will contact the applicant within 4 to 6 weeks after receipt of the application.
Eligibility Guidelines The applicant must be a US citizen, have a diagnosis of a brain tumor and meetin income requirements. There is a page that needs to be filled out by a doctor, nurse, or hospital social worker.
How To Apply Call the Society or go to the website to get the application and more information
Area of Service National

Program Name Cancer Services of Northeast Indiana
Program Address 6316 Mutual Drive
Fort Wayne, IN 46825
Phone Number 260-484-9560
Fax Number 260-484-9572
Email webmaster@cancer-services.org
Diseases Cancer, Brain Tumor
Details This program provides assistance to cancer patients who live in Northeast Indiana including financial assistance, transportation to and from treatment, medical equipment, wigs, nutritional supplements and other forms of assistance.
Eligibility Guidelines Have a diagnosis of cancer or brain tumor; Live in one of the following counties: Allen, Adams, DeKalb, Huntington, Kosciusko, Lagrange, Noble, Steuben, Wabash, Wells, or Whitley and have a need for assistance.
How To Apply To apply for assistance contact the program directly, or visit the program website, complete an Intake Form and meet with a client advocate to assess your needs.
Area of Service Northeast Indiana

Program Name Friends for Michael Foundation
Program Address 8 Ironworks Road
Monroe, NY 10950
Phone Number 845-781-7367
Diseases Brain Tumors
Details This foundation provides financial assistance to families with financial needs resulting from expenses associated with their child's brain tumor treatment. This program covers specific non-medical costs related to a primary brain tumor diagnosis. Direct medical expenses are not covered
Eligibility Guidelines Child must be under age 18 at time of diagnosis and must be undergoing treatment for a Brain Tumor.
How To Apply Requests for assistance must be submitted by a certified Social Worker working on behalf of the family. The request must also be validated by a member of the FAC. Visit program website to review application requirements.
Area of Service National

Program Name National Brain Tumor Foundation Patient Help Fund
Program Address 22 Battery Street, Suite 612
San Francisco, CA 94111
Phone Number 800-934-2873
415-834-9970
Email nbtf@braintumor.org
Diseases Brain Tumors
Details This program provides financial assistance to Brain Tumor patients through its Patient Help Fund. The Patient Help Fund assists patients with treatment-related expenses, medication copays, and transportation to treatment. Financial assistance applications are reviewed on a monthly basis, and awards range from $100 to $1,000.
Eligibility Guidelines Diagnosed with a brain tumor and have a financial need.
How To Apply Contact the program directly and an application will be sent to you.
Area of Service National

Program Name The Kelly Heinz-Grundner Berain Tumor Foundation Whatever It Takes Initiative
Program Address 300 Water Street, Suite 103
Wilmington, DE 19801
Phone Number 302-427-2280
Email diane.freed@khgbraintumorfoundation.org
Diseases Brain Tumors
Details This program provides needed financial support to brain tumor patients and their families who live in Michigan, Western New York or Delaware. Contact the program directly for detailed information on what expenses are covered.
Eligibility Guidelines Have a brain tumor diagnosis, live in one of the covered states and be in need.
How To Apply Contact the program directly to request an application
Area of Service Michigan Western New York Delaware

Program Name The Michael Quinlan Brain Tumor Foundation
Program Address 4012 Dupont Circle, Suite 411
Louisville, KY 40207
Phone Number 501-896-1701
Fax Number 502-899-9828
Email kathy.quinlan@mqbtf.org
Diseases Brain Tumors
Details This program provides financial assistance in the form of $500.00 per family per year to residents of Kentucky who have a brain tumor diagnosis and are in need of financial assistance.
Eligibility Guidelines Have a brain tumor diagnosis, reside in Kentucky and be in need.
How To Apply Contact the program directly to apply for assistance.
Area of Service Kentucky

Breast Cancer and Cervical Cancer

Program Name Breast and Cervical Cancer Diagnosis and Treatment Program of Maryland
Program Address 201 West Preston Street, Room 306
Baltimore, MD 21201
Phone Number 410-767-5300
Fax Number 410-333-7106
Diseases Breast Cancer, Cervical Cancer
Details This program will provide health services to women diagnosed with breast or cervical cancer who live in Maryland. The services include: breast/cervical cancer diagnostic procedures (including ultrasound, biopsy, colposcopy, surgical consultations, etc.), breast/cervical cancer treatments (including cryotherapy, laser hysterectomy, lumpectomy, mastectomy, radiation therapy, and chemotherapy), medications required for the treatment, medical equipment when required because of the cancer, breast prosthesis, bras, wigs, and breast reconstruction.
Eligibility Guidelines Must be a Maryland resident and meet income and insurance coverage guidelines as determined by the program.
How To Apply Women can obtain applications to enroll in the program from the program coordinator at their local health department or from the Maryland Department of Health and Mental Hygiene, Division of Cancer Control. Applications can also be completed at the offices of participating providers.
Area of Service Maryland

Program Name Breast and Cervical Cancer Program (BCCP)
Phone Number 303-866-2693
Email
Diseases Breast Cancer, Cervical Cancer
Details Women who meet the eligibility requirements and who have breast or cervical cancer are allowed presumptive eligibility into the Medicaid program and begin receiving full Medicaid benefits for treatment of their condition, thereby hopefully reducing breast and cervical cancer mortality.
Eligibility Guidelines Applicant must 1) be under age 65, 2) be a resident of Colorado and a US citizen (or qualified immigrant), 3) have income 250% or less of the Federal Poverty Level, 4) have been screened at a Colorado Women's Cancer Control Initiative (CWCCI) site and need treatment for breast or cervical cancer, and 5) have no other medical coverage, including qualifying for other Medicaid programs.
How To Apply Contact Ginger Burton, BCCP Coordinator, Colorado Department of Health Care Policy and Financing, at 303-866-2693.
Area of Service Colorado

Program Name CancerCare Co-Payment Assistance Foundation
Program Address 275 Seventh Avenue, 22nd Floor
New York, NY 10001
Phone Number 866-552-6729
212-601-9750
Email information@cancercarecopay.org
Diseases Breast Cancer, Lung Cancer, Colon or Colorectal Cancer and Pancreatic Cancer
Details This foundation provides financial assistance to Breast Cancer, Lung Cancer, Colon or Colorectal Cancer and Pancreatic Cancer patients to cover the costs of co-payments for cancer medications.
Eligibility Guidelines To be eligible for co-payment assistance the applicant must be diagnosed with one of the cancer types that the Foundation covers, the diagnosis must be verified by a doctor, applicants must receive treatment dispensed in the United States and the medication must be approved by the Food and Drug Administration (FDA) for cancer. Applicants must also 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. Grants assistance on a first-come, first-served basis, to the extent that funding is available.
How To Apply Call 1-866-55-COPAY to determine if you are eligible and begin the application process.
Area of Service National

Program Name Chronic Disease Fund
Program Address 10880 John W. Elliott Drive, Suite 400
Frisco, TX 75034
Phone Number 877-968-7233
972-712-0201
Fax Number 214-975-1114
Email info@cdfund.org
Diseases Age Related Macular Degeneration, Ankylosing Spondylitis, Asthma, Breast Cancer, Colorectal Cancer, Growth Hormone Deficiency, Multiple Myeloma, Multiple Sclerosis, Myelodysplastic Syndrome, Non-Small Cell Lung Cancer, Psoriasis, Pulmonary Arterial Hypertension, Rheumatoid Arthritis.
Details This program provides financial assistance to insured patients by covering the out-of-pocket expenses associated with prescription drug plans.
Eligibility Guidelines The applicant must meet eligibility requirements, including treatment of a covered disease state, insurance documentation and proof of income.
How To Apply The application can be downloaded from the website, or by calling the above toll-free number. The completed application must include proof of income, a copy of each insurance card, and a signed HIPAA Authorization.
Area of Service National

Program Name Co-Pay Relief
Program Address 700 Thimble Shoals Blvd
Suite 201
Newport, VA 23606
Phone Number 866-512-3861
Diseases Breast, Lung, Prostate, Kidney, Colon and Pancreatic cancers, Sarcomas, Lymphoma, Macular Degeneration, Low Blood counts due to Chemotherapy, Diabetes, and Rheumatoid Arthritis, Psoriatic Arthritis and Crohn's Disease.
Details Counselors assist patients throughout the entire application process, screening for eligibility by collecting financial and medical information from everyone who calls to apply for the Program.
Eligibility Guidelines This is a co-pay assistance program, the applicant must have insurance. The applicant must also be a US citizen.
How To Apply Call the above number to get more information and request an application.
Area of Service Nationwide

Program Name Kommah Seray Inflammatory Breast Cancer Foundation (KSIBCF)
Program Address P.O. Box 1098
Pomona, CA 91769
Phone Number 909- 247-0051
Email info@ksinflammatorybreastcancer.org
Diseases Breast Cancer
Details This program will provide assistance to patients who are in active treatment, or within two months of having surgery for Inflammatory Breast Cancer. The assistance includes financial assistance for prescription drug costs, Lymphedema and post-surgery garments, household utility bills, gift cards to grocery stores and renting loaner equipment such as canes, walkers or wheelchairs.
Eligibility Guidelines Applicants for assistance must be in active treatment or within two months of having surgery for cancer, and must have been financially affected by cancer and the treatment process.
How To Apply Contact the program directly to apply for assistance
Area of Service National

Program Name Mickaela Foundation
Program Address PO Box 354
Henderson, CO 80640
Phone Number 303-452-1898
Fax Number 303-452-1031
Diseases Breast Cancer
Details This program provides post diagnostic medically related bills for residents with breast cancer. The program will provide up to $1000 per award per month. Patients may re-appy every month.
Eligibility Guidelines The applicant must be a resident of Colorado, have a dianosis of breast cancer, must have some degree of verifiable employment at the time of application or diagnosis. The applicant's income must also have an income between $8,000-$30,000 for a single ( $8000-$36000 for a single w/ dependent, $12000-$50000 for a family w/ less 3-5 dependents)
How To Apply The application can be downloaded from the website or call the foundation for an application.
Area of Service Colorado

Program Name Sense of Security
Program Address PO Box 6098
Broomfield, CO 80021
Phone Number 303-669-3113
866-736-3113
Email info@senseofsecurity.org
Diseases Breast Cancer
Details This foundation has 4 different financial assistance programs for patients with breast cancer.
1. Sustained Assistance Program can fund the following expenses while you are in qualified treatments for breast cancer: mortgage or rent, medical insurance premiums, transportation costs, child care, utilities, and food and groceries. The monthly cap is $1,000 and the maxium duration is 12 months.
2. Emergancy Fund is a one time aid program for up to $250 for an emergancy situation such as eviction, repossession or shutoff notices.
3. Transportation Fund is another one time aid for up to $250 to provide gas, car repair, car payment, or insurance payment or renewal.
4. Household Fund is another one time aid program for up to $250 to provide groceries or household items.
Eligibility Guidelines The applicant must be a resident of Colorado, and must be receiving a qualifying treatment for or recovering from a qualifying surgery after a diagnosis of breast cancer. Applicants can be in any phase of a qualifying treatment for breast cancer or must be within two months of a qualifying breast cancer surgery. Applicants must also have exhausted all other forms assistance. There are also financial criteria for the programs, contact the foundation for more information.
How To Apply There are two applications, one for The Sustained Assistance Program, and one for the other three programs. Both are available on the website, or call the program for more information. Proof of residency, medical state and financial sitaution is required with the application.
Area of Service Colorado

Program Name Susan G. Komen Breast Cancer Foundation (PAF Co-Pay Relief Fund)
Phone Number 866-512-3861
Diseases Breast Cancer
Details Funds made available by this foundation will provide direct financial support for pharmaceutical co-payments incurred by insured patients, including new Medicare Part D beneficiaries diagnosed with breast cancer.
Eligibility Guidelines Breast Cancer patients must financially and medically qualify to access co-payment assistance. Contact the program directly to begin the application process
How To Apply The patient completes an application on the phone with a call counselor .The completed application is then sent to the caller/applicant for review and signature. The PAF CPR call counselor works directly with the patient as well as the provider of care to obtain necessary medical, insurance and income certification in an expeditious manner.
Area of Service National

Burn Injuries

Program Name Alisa Ann Ruch Burn Foundation
Program Address Southern CA Office
3100 W Burbank Blvd, #204
Burbank, CA 91505
Phone Number 818-848-0223
800-242-2876
Fax Number 818-848-0296
Diseases Burn Injury
Details This foundation will assist burn victims in California who are in financial need. There are a variety of programs, including summer camps for kids, Bridge-to-Life Scholarship Fund for high school graduates, an Adult Survivor Family Camp, support groups, peer support, workshops, conferences and two financial assistance programs. The General Assistance Program will aid in burn survivors meet their needs as it directly relates to their burn injury, This assistance will provide assistant with housing, food, clothing, and image enhancement. The Special Assistance Program will attempt to subsidize or find resources for special needs associated with a burn injury including transportation to and from the hospital, pressure garments, permanent makeup, camouflage consultations and wigs.
Eligibility Guidelines The applicant must live in California and be a burn survivor.
How To Apply Contact the foundation for more information. Personal information is required and in some instances a written application is mandatory. All requests are evaluated on an individual basis. For the Northern California office call 415-495-7223 (800-755-2876) For the Central California office call 559-224-7223 (888-49-2876)
Area of Service California

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Web Site http://www.dhcs.ca.gov/services/ccs/Pages/default.aspx
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Program Name Shriners Hospitals for Children
Program Address PO Box 31356
Tampa, FL 33621
Phone Number 800-237-5055
Diseases Orthopedic Conditions, Burn Injuries, Spinal Cord Rehabilitation, Cleft Lip, Palate Repair.
Web Site No link available.
Details Shriners Hospitals for Children are located throughout the United States and the hopsitals provided free care to children whom have a reasonable possibility that the child's condition can be helped by the the hospital.
Eligibility Guidelines The child must be under the age of 18. There are not any income limits.
How To Apply Call the program or go to the website to get an application.
Area of Service National

Cancer

Program Name Adam Bullen Memorial Foundation
Program Address 24 Charlton Street
Oxford, MA 01540
Phone Number 508-987-5999
Fax Number 508-987-6110
Email bullenfoundation@charterinternet.com
Diseases Any form of Cancer
Details This program provides financial assistance, as well as transportation, clothing, meals, groceries, medical equipment, videos and referrals to cancer patients and their families in order to help them through the many stages of this life threatening disease.
Eligibility Guidelines Have a diagnosis of cancer, live in Massachusetts and require needed support.
How To Apply Contact the program directly to apply for assistance
Area of Service Massachusetts

Program Name Alabama Foundation for Oncology
Program Address PO Box 660833
Birmingham, AL 35266
Phone Number 205-877-2224
205-877-2225
Fax Number 205-877-1821
Diseases Any form of Cancer
Details This is a grant for cancer patients in the Greater Birmingham area to assist with critical needs like housing, food, and utilities up to $500. If accepted, the program pays the bills directly.
Eligibility Guidelines The applicant must be undergoing treatment or within the hospice setting and be within the Greater Birmingham area.
How To Apply A doctor, social worker or oncology nurse must call to get a request form, fill it out and mail it back for the applicant. A written request is needed explaining the situation surrounding the request, a defined request with the amount needed, a description of other resrouces being accessed or attempted to fulfill the patient's needs and a definition of a time period when assistance will be needed.
Area of Service Greater Birmingham area of Alabama

Program Name American Cancer Society
Program Address 1599 Clifton Rd., NE
Atlanta, GA 30329-4251
Phone Number 800-ACS-2345
Diseases Any form of Cancer
Web Site http://www.cancer.org/docroot/home/index.asp
Details Each local office of the American Cancer Society may have different programs to help with expenses related to cancer treatment, including transportation, medicine, medical supplies and lodging.
Eligibility Guidelines Not specified.
How To Apply Call the above number or go on-line to find a local chapter to get an application
Area of Service The local chapters administer the different programs

Program Name Bear Necessities Pediatric Cancer Foundation Small Miracle Program
Program Address 23 W. Hubbard Street, 3rd Floor
Chicago, IL 60610
Phone Number 312-836-2327
Fax Number 312-836-1284
Email office@bearnecessities.org
Diseases Pediatric Cancer
Details This program provides assistance with housing and transportation expenses, as well as providing wigs, phone cards, event tickets and other "gifts" to the families of pediatric cancer patients who are residents of Illinois or patients who are being treated at an approved Illinois facility.
Eligibility Guidelines Applicants must be a pediatric cancer patient, live in Illinois or be receiving treatment at an Illinois facility listed on the program website and have a need for assistance.
How To Apply Contact the program directly to apply for assistance.
Area of Service Illinois

Program Address Purchase of Medical Care Services
1904 Mail Service Center
Raleigh, NC 27699
Fax Number 919-733-0352
Diseases Any form of Cancer
Web Site http://www.communityhealth.dhhs.state.nc.us/cancer/ccp.htm
Details This program will residents with inpatient and/or outpatient diagnostic services of cancer or suspected malignancies and for the treatment of cancer. The program covers up to 8 days of service for the diagnosis of cancer (inpatient or outpatient) and up to 30 days of cancer patient treatment services (inpatient or outpatient) per state fiscal year. Follow-up services may be covered for up to 2 days if they fall within the 8- or 30-day limit. For maximum benefit to the patient, several services can be provided each day.
Eligibility Guidelines The applicant must be a permanent resident of North Carolina,be at or below 115% of the Federal Poverty Level, and be ineligible for other medical assistance programs (e.g., Medicaid) or have limited or no health insurance. The applicant must also have symptoms or clinical findings suspicious of cancer or be diagnosed as having cancer and have an estimated 25 percent or better chance of five-year survival rate at the time each treatment is requested.
How To Apply The application and forms are available on line. The Financial Eligibility Application must be filled out by a financial interviewer. (Staff in physicians' offices, hospitals and health departments serves as interviewers as do representatives of designated community service agencies.) The Authorization Request must also be filled out and signed by the provider.
Area of Service North Carolina

Program Name Cancer Association for Auglaize County
Program Address 120 S. Front St.
PO Box 252
St Marys, OH 45885
Phone Number 419-300-3556
419-394-3556
Email jbjhans@bright.net
Diseases Any form of Cancer
Web Site No link available.
Details This program assists patients with cancer who need assistance who live in Auglaize County. This program provides wigs, turbans, mileage reimbursement to treatment centers, nutritional supplements, medical or surgical need and financial assistance to those in need.
Eligibility Guidelines The patient must be a resident of Auglaize County and have cancer.
How To Apply Contact the program to apply.
Area of Service Auglaize County, Ohio

Program Name Cancer Association Of Greater New Orleans (CAGNO)
Program Address 824 Elmwood Park Blvd
New Orleans, LA 70123
Phone Number 504-733-5539
800-624-2039
Fax Number 504-733-0252
Email director@cagno.org
Diseases Any form of Cancer
Details This program can help cover the costs of prescription pain and treatment medications, colostomy bags and comfort items (bedpads, etc.) for cancer patients who cannot afford these necessities and/or "fall through the cracks" of government assistance. Cancer patients currently residing in the parishes of Jefferson, Orleans, Plaquemines, St. Bernard, St. Tammany and Tangipahoa also qualify to receive up to $1,500 in additional assistance with medical supplies or equipment, medical expenses (co-pays, insurance premiums, medical and hospital bills), living expenses and transportation.
Eligibility Guidelines Cancer patients who live in the service area and are in need of assistance.
How To Apply Visit the program website and complete a patient services application form, or contact the program directly.
Area of Service New Orleans

Program Name Cancer Care Assist
Program Address 275 Seventh Avenue
22nd Floor
New York, NY 10001
Phone Number 212-712-8085
800-813-4673
Fax Number 212-712-8495
Email info@cancercare.org
Diseases Any form of Cancer
Details CancerCare administers many different support programs for patients with cancer. Some programs are national, others are local. If a patient needs finanicial assistance, s/he should call the above number to find out if there an appropriate program. This program provides assistance for certain medical expenses. The program does not cover basic living expenses.
Eligibility Guidelines Not specified.
How To Apply The application can be downloaded from the website, or call the program for info.
Area of Service Nationwide

Program Name Cancer Care Services
Program Address 623 S. Henderson Street
Fort Worth, TX 76104
Phone Number 817-921-0653
800-789-9944
Fax Number 817-921-1701
Email info2@cancercareservices.org
Diseases Cancer
Details This program provides financial assistance to patients in active treatment for cancer related medications, nutritional supplements, equipment, supplies, transportation, dental care (if needed to begin treatment), Cobra health insurance premiums and limited emergency funds. The amount of financial assistance is based on a sliding scale based on household size and net monthly income.
Eligibility Guidelines Must be in active treatment for cancer and live in the service area
How To Apply Call the program, or visit the program website to apply
Area of Service Tarrant, Johnson, Hood, and Parker Counties in Texas

Program Name Cancer Fund Of America, Inc.
Program Address 2901 Breezewood Lane
Knoxville, TN 37921
Phone Number 800-578-5284
Diseases Any form of Cancer
Details This program provides supplies and equipment to cancer patients free of charge including Liquid Nutritional Supplements and Vitamins, Adult Diapers, Bed Pads, and Exam Gloves, Fans and Seasonal Gift Boxes, Crutches, Lotions, and Ointments, Food Items and Various Medical Supplies and Non-Precription Medicine, Toys, Clothing, and Hygiene Kits.
Eligibility Guidelines Cancer patient with a qualifying need. Contact the program directly for further information on eligibility guidelines.
How To Apply Download the application to be completed by the patient and health care professional and send it back to the program.
Area of Service National

Program Name Cancer Services of Greater Baton Rouge
Program Address 550 Lobdell Ave
Baton Rouge, LA 70806
Phone Number 225-927-1329
800-883-4515
Fax Number 225-927-1468
Diseases Any form of Cancer
Details This program provides limited financial assistance towards medical needs and supplies. This program also provides assistance in finding, and applying to patient assistance programs as well as educational resources, referrals and advocacy services.
Eligibility Guidelines The applicant needs to live in on of the served parishes and be living with cancer.
How To Apply The application can be dowloaded from the website, or contact the program for more info.
Area of Service Ascension, EBR, East Feliciana Iberville, Livingston, Pointe Coupee, St. Helena, St. James, WBR, and West Feliciana parishes of Louisiana

Program Name Cancer Services, Inc
Program Address 3175 Maplewood Ave
Winston-Salem, NC 27103
Phone Number 336-760-9983
800-288-7421
Fax Number 336-760-1282
Email csi1955@cancerservicesonline.org
Diseases Any form of Cancer
Details This program provides medication and financial assistance. The program will also help in finding and applying to patient assistance programs, peer support, education programs, conferences, breast cancer support program, prostheses, bras, medical supplies, equipment, wigs, turbans, hats, transportation assistance, information and patient advocacy to patients with any form of cancer at any stage of the diagnosis.
Eligibility Guidelines Live in one of the counties below, have a diagnosis of cancer and be in need.
How To Apply For financial assistance and medication assistance an interview is required. Call or email the foundation to set up the interview. All other services are available at any time.
Area of Service Forsyth, Davie, Stokes and Yadkin counties of North Carolina

Program Name Children's Leukemia Foundation of Michigan
Program Address 29777 Telegraph Rd.
Suite 1651
Southfield, MI 48034
Phone Number 248-353-8222
800-825-2536
Fax Number 248-353-0157
Diseases Leukemia, Non-Hodgkin's Lymphoma, Hodgkin's Disease, Multiple Myeloma, Aplastic Anemia, Fanconi's Anemia, Myelodysplastic Syndromes, Myelopreliferative Disorders, and Waldenstrom's Macroglobulinemia.
Details This foundation provides financial assistance to families of adults and children affected by leukemia, lymphoma, and other related blood disorders, as well as emotional support and information. The program will provide up to $1,000 per fiscal year toward the costs of treatments, prescriptions, travel to and from treatment centers, wigs and head-coverings. There is also a Special Needs Fund which will provide up to $500 (which is seperate from the above fund) to cover the expenses that fall through the cracks of traditional financial aid programs (e.g. lodging, rent/mortgage, auto repairs, child care, etc.)
Eligibility Guidelines The applicant must be residing in Michigan, and have been diagnosed with a malignant or potentially malignant disorder of the blood, lymphatic system or bone marrow.
How To Apply Contact the program for more information and how to apply.
Area of Service Michigan

Name Community Cancer Network
Program Address PO Box 4499
Lafayette, IN 47903
Phone Number 888-523-2261
765-446-5220
Email mbond@communitycancernetwork.org
Diseases Cancer
Details This program provides financial assistance for housing, utilities, pharmacy, communications and transport; Groceries, hot meals and nutritional support; Transportation to and from treatment; Cosmetic assistance for wigs, makeup, and other appearance articles and other services to cancer patients in treatment who live in the Indiana service area.
Eligibility Guidelines Applicants must be in treatment for cancer and live in one of the eleven counties serviced by the program.
How To Apply Contact the program by telephone to apply for assistance.
Area of Service Eleven Mid-Northern Indiana Counties

Program Name GlaxoSmithKline Hope for Families Fund/Children's Hospital of Philadelphia
Program Address 34th Street and Civic Center Boulevard
Philadelphia, PA 19104
Phone Number 267-426-6071
215-590-1000
Email mooreal@email.chop.edu
Diseases Relapsed Cancers
Details This fund will provide financial assistance to families of children being treated at Children's Hospital of Philadelphia for relapsed cancers to help with the costs of travel expenses including gas, plane tickets, taxi fares, and provide food vouchers, hotels and other necessary travel expenditures for the patient and a parent or family member.
Eligibility Guidelines Applicants must have a child being treated for relapsed cancers at Children's Hospital of Philadelphia and demonstrate a financial need.
How To Apply Contact the program directly to apply for assistance
Area of Service National

Program Name HealthWell Foundation
Program Address P.O Box 4133
Gaithersburg, MD 20885-
Phone Number 800-675-8416
Fax Number 800-282-7692
Diseases Acute Porphyrias, Age-Related Macular Degeneration, Anemia associated with Chronic Renal Insuffiency or Chronic Renal Failure, Ankylosing Spondylitis, Asthma, Moderate to Severe Breast Cancer, Carcinoid Tumors and Associated Symptoms, Chemotherapy Induced Anemia/Chemotherapy Induced Neutropenia, Idiopathic Thrombocytopenia Purpura (ITP), Colorectal Carcinoma, Cutaneous T-Cell Lymphoma, Head Cancer, Neck Cancer, Hodgkin's Disease, Immunosuppressive Treatment for Solid Organ Transplant Recipients, Iron Overload as a Result of Blood Transfusions, Multiple Myeloma, Myelodysplastic Syndromes, Non-Hodgkin's Lymphoma, Non-Small Cell Lung Cancer, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Secondary Hyperparathyroidism, Wilms' Tumor
Details This program helps pay for medical expenses including: medications, copayments, insurance premiums and other out-of-pocket healthcare costs. If accepted into the program, the patient is covered for up to one year. Accepted patients must submit invoices or receipts to reveice monetary awards. The foundation typically sends awards directly to the insurer, pharmacy, physician, or other provider. However, in some cases it may send awards directly to patients to reimburse them for expenses they must pay themselves.
Eligibility Guidelines Individuals covered by private insurance, employer-sponsored plans, Medicare or Medicaid may be eligible.The families income must be at or below 400% of the Federal Poverty Level, and state cost of living is also taken into account.
How To Apply Call the above number to get an application or apply on line.
Area of Service National

Name HOPE's Patient Assistance
Program Address 2049 Point Circle
Suite 1
Fayetteville, AR 72704
Phone Number 479-571-4673
800-394-0249
Fax Number 479-443-6001
Diseases Any form of Cancer
Details Helps cancer patients with prescription assistance, PAP applications help, emergency assistance for housing and transportation needs, counseling services
Eligibility Guidelines Any cancer patient in active treatment who lives or is being treated in Northwest Arkansas.
How To Apply Call or go online for an application.
Area of Service Northwest Arkansas

Name Jennifer L. Collins Memorial Foundation
Program Address PO Box 80742
Seattle, WA 98108
Phone Number 2067237809
Fax Number 206-723-0315
Email mark@jensfriends.com
Diseases Cancer
Details This program will provide financial support to cancer patients who live in the Pacific Northwest to help pay for travel expenses to and from doctors appointments, child care during treatments, prescription and insurance co-pays, groceries, educational materials, holiday gifts for cancer kids & their families and other needed support
Eligibility Guidelines Must be a cancer patient living in the Pacific Northwest and have a financial need.
How To Apply Contact the foundation by email or phone to apply
Area of Service Pacific Northwest

Program Name John's Cancer Foundation
Program Address PO Box 13014
Richmond, VI 23235
Phone Number 804-330-2300
804-330-2136
Fax Number 804-330-2174
Diseases Any form of Cancer
Details This program provides grants of up to $500 for non-medical needs of cancer patients in Richmond and the surrounding counties. This fund can help pay for home care equipement rental or expenses of everyday living when the high cost of cancer treatment makes ordinary bill-paying unusually difficult.
Eligibility Guidelines The applicant must living in Richmond or a surrounding county, have a diagnosis of cancer and be in financial need.
How To Apply Call the program for more information or download the application from the webiste.
Area of Service Richmond Virginia surrounding counties

Program Name Leukemia & Lymphoma Society Co-Pay Assistance Program
Program Address 1311 Mamaroneck Ave, Suite 310
White Plains, NY 10605
Phone Number 877-557-2672
Fax Number 914-949-6691
Email copay@LLS.org
Diseases Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Leukemia and Multiple Myeloma
Details This program helps with financial assistance of up to $5000 to help with the cost of medical procedures, prescription medications, and transportation to and from doctor's office, hospital, treatment center or support group.
Eligibility Guidelines Patient financial aid is limited to residents of the United States or its territories, and U.S. military personnel stationed abroad who have incomes at or below 500% of the federal poverty level. If accepted into the program, the patient is sent a check for reimbursement.
How To Apply Contact the program via phone or website to request an application.
Area of Service National

Program Name Leukemia & Lymphoma Society Patient Financial Aid
Program Address 1311 Mamaroneck Ave, Suite 310
White Plains, NY 10605
Phone Number 877-557-2672
Fax Number 914-949-6691
Diseases Leukemia, Lymphoma, Myeloma, MDS or another blood cancer
Details This program provides supplementary financial assistance of up to $500.00 to patients with Leukemia, Lymphoma, Myeloma, MDS or another blood cancer in significant financial need to help cover the costs of medical care. Types of services covered by the Patient Financial Aid program include specific approved drugs related to the treatment/control of leukemia, Hodgkin and non-Hodgkin lymphoma and myeloma, processing, typing, screening and cross-matching of blood components for transfusions, infusion of marrow, cord blood or stem cells, transportation costs to and from a doctor's office, hospital, treatment center or family support group, initial induction x-ray therapy, x-ray therapy or other procedures according to the specific approval of the national Patient Services Committee.
Eligibility Guidelines Any U.S. resident undergoing treatment for leukemia, lymphoma, myeloma, MDS or another blood cancer may apply for financial aid. If you are a member of the U.S. military serving abroad, and you or your family are being treated in your current country of residence, you are eligible to apply. Contact your local chapter of The Leukemia & Lymphoma Society for further details on eligibility guidelines.
How To Apply Complete an application and send it to your local chapter. You can find your local Chapter by calling (800) 955-4572 or visiting www.LLS.org and clicking on Chapter Finder. Applicants will be contacted within 7 business days.
Area of Service National

Program Name Meredith & Jeannie Ray Cancer Center Patient Assistance Fund
Program Address 255 North 30th Street
Laramie, WY 82072
Phone Number 307-742-7586
Fax Number 307-742-0286
Diseases Any form of Cancer
Details This program provides financial assistance to cancer patients who are receiving treatment at the Meredith & Jeannie Ray Cancer Center/Ivinson Memorial Hospital to help cover the costs of medication, travel to and from treatment, lodging, utilities and other expenses.
Eligibility Guidelines Patients receiving cancer related treatment at the Meredith & Jeannie Ray Cancer Center/Ivinson Memorial Hospital.
How To Apply Contact the program directly to apply for assistance
Area of Service Wyoming

Program Name Mission of Hope Cancer Fund
Program Address 1101 Pringle Avenue
Jackson, MI 49203
Phone Number 888-544-6423
517-782-4643
Fax Number 517-768-2246
Email mhcf@cancerfund.org
Diseases Any form of Cancer
Details This fund provides financial assistance to cancer patients and their families during treatment and recovery to help pay the costs of medical expenses, prescriptions, co-pays, insurance premiums and travel to and from treatment.
Eligibility Guidelines You must have a diagnosis of cancer, be in treatment and/or recovery and reside in Florida or Michigan.
How To Apply Apply using Request For Assistance Form on the program website or call the program directly.
Area of Service Michigan and Florida

Program Name Mission Of Hope Cancer Fund
Program Address 1101 Pringle Avenue
Jackson, MI 49203
Phone Number 888-544-6423
517-782-4643
Fax Number 517-768-2246
Email
Diseases Any form of Cancer
Details This program provides financial assistance to cancer patients who are in treatment and/or recovery to pay for the costs of medical expenses, prescriptions, co-pays, insurance premiums and transportation to and from treatment.
Eligibility Guidelines Applicants must have a diagnosis of cancer, be in treatment and/or recovery and live in Florida or Michigan.
How To Apply Complete a Request For Assistance Form on the programs website or call the program directly.
Area of Service Michigan and Florida

Program Name NMMC Cancer Patient Assistance Fund
Program Address 830 South Gloster Street
Tupelo, MS 38801
Phone Number 662- 377-3000
Diseases Any form of Cancer
Details This program provides anti-nausea medication, pain medication, nutritional supplements and transportation to and from treatment to cancer patients receiving treatment at the NMMC Cancer Center.
Eligibility Guidelines Have a diagnosis of cancer, a need for assistance and be receiving treatment at the NMMC Cancer Center.
How To Apply Contact the program directly to apply for assistance.
Area of Service Mississippi

Program Name Patient Access Network Foundation
Program Address P.O. Box 221858
Charlotte, NC 28222-
Phone Number 866-316-7263
Fax Number 866-316-7261
Email
Diseases Age Related Macular Degeneration, Anemia, Ankylosing Spondylitis, Breast Cancer, Colorectal Cancer, Crohn's Disease, Cutaneous T-Cell Lymphoma, Cystic Fibrosis, Gaucher's Disease, Growth Hormone Deficiency, Multiple Myeloma, Multiple Sclerosis, Myelodysplastic Syndrome, Non-Hodgkin's Lymphoma, Oncology Cytoprotection, Pancreatic Cancer, Plaque Psoriasis, Rheumatoid Arthritis , Respiratory Syncytial Virus
Details This program helps pay for medical expenses including: medications, co-payments, insurance premiums and other out of pocket health care costs.
Each disease has it's own application.
Eligibility Guidelines Individuals must be U.S. residents and meet certain financial, medical and insurance criteria as set by the Foundation's board of directors.
How To Apply Call the above number to get an application or apply on line.
Area of Service Nationwide

Program Name Patient Advocate Foundation (PAF) Co-Pay Relief Program
Program Address 700 Thimble Shoals Boulevard
Newport News, VA 23606
Phone Number 866-512-3861
757-952-0118
Fax Number 757-952-0119
Diseases Breast, Lung, Prostate, Kidney, Colon, Pancreatic, Head/Neck Cancers, Malignant Brain Tumor, Sarcoma, Diabetes, Multiple Myeloma, Myelodsyplastic Syndrome (and other pre-leukemia diseases), Osteoporosis, Pain, Hepatitis C, Rheumatoid Arthritis, Selected Autoimmune Disorders and CIA/CIN.
Details This program provides direct financial support to insured patients for co-payments, including Medicare Part D beneficiaries, who must financially and medically qualify to access pharmaceutical co-payment assistance. The program currently assists Patients being treated for breast, lung, prostate, kidney, colon, pancreatic, head/neck cancers, malignant brain tumor, sarcoma, diabetes, multiple myeloma, myelodsyplastic syndrome (and other pre-leukemia diseases), osteoporosis, pain, hepatitis C, rheumatoid arthritis, selected autoimmune disorders and CIA/CIN.
Eligibility Guidelines Applicants must be being treated for one of the program covered conditions and demonstrate a financial need.
How To Apply Contact the program directly or visit the program website to begin the application process
Area of Service National

Program Name Patient Transportation Assistance Program of the American Cancer Society
Program Address 4110 S. 100th East Avenue #101
Tulsa, OK 74146
Phone Number 918-477-6767
800-227-2345
Diseases Cancer
Web Site No link available.
Details This program provides direct financial aid for gasoline costs or transportation reimbursement in the form of a $50 gas gift card to cancer patients who lack the human and/or financial resources to find transportation to and from their treatment.
Eligibility Guidelines Must be a resident of Oklahoma being treated for cancer and lack the resources to obtain transportation to and from treatment.
How To Apply Contact the program directly to apply for assistance
Area of Service Oklahoma

Program Name RiverBend Cancer Services
Program Address 919 E. Jefferson Blvd.
Suite 401
South Bend, IN 46617
Phone Number 574-287-4197
Fax Number 574-287-4393
Email Info@RiverBendCancerServices.org
Diseases Cancer
Details This program provides financial assistance to residents of St. Joseph County, IN for prescriptions and supplies, nutritional supplements, durable medical equipment, counseling and social work services.
Eligibility Guidelines Contact the program directly for information on eligibility guidelines.
How To Apply Contact the program directly to apply for assistance.
Area of Service St. Joseph County, Indiana

Program Name The Chain Fund
Program Address PO Box 6344
Hamden, CT 06517,
Phone Number 203-530-3439
Diseases Any form of Cancer
Details This fund provides financial assistance to cancer patients for medical and personal expenses including rent, utilities, mortgage, prescription co-pays, insurance co-pays and special food needs. Funds are paid directly to the vendors, not the applicant.
Eligibility Guidelines You must reside in Connecticut and have a diagnosis of cancer. Contact the program directly for additional eligibility requirements.
How To Apply Contact the program directly or visit the website.
Area of Service Connecticut

Program Name The Keaton Raphael Memorial for Neuroblastoma, Inc. Family Grant
Program Address 970 Reserve Drive, Suite 144
Roseville, CA 95678
Phone Number 916-784-6786
775-327-6275
Fax Number 916-784-3384
Email Info@ChildCancer.org
Diseases Childhood Cancer
Details This program provides direct financial support to families with children who have been diagnosed with cancer, live in Northern California and are being treated in an accredited institution to help cover the costs of household expenses, insurance premiums/co-pays and other bills. Gas, telephone and grocery cards are also included, as well other gift cards.
Eligibility Guidelines Childhood cancer patients and their families who reside in and are being treated for childhood cancer at an accredited institution in Northern California.
How To Apply Contact the program directly to apply for assistance.
Area of Service Northern California

Program Address 35 Channel Center St. #208
Boston, MA 02210
Phone Number unavailable
Fax Number unavailable
Email info@thesamfund.org
Diseases Cancer
Web Site http://www.thesamfund.org/pages/grants.html
Details Grants and scholarships provided by this program cover a wide range of post-treatment financial needs, such as (but not limited to): undergraduate & graduate tuition and loans, car and health insurance premiums, rent, utilities, current and residual medical bills, fertility-related expenses, gym memberships and transportation costs.
Eligibility Guidelines Applicants must have had cancer, be finished with active treatment, between the ages of 17 and 35 and be a US resident.
How To Apply Contact the program via mail, email or visit the program website and complete an Inquiry Form to apply for assistance.
Area of Service National

Program Name The Tomorrow Fund
Program Address RI Hospital Campus
593 Eddy Street
Providence, RI 02903
Phone Number 401-444-8811
Fax Number 401-444-4542
Email bducharme@lifespan.org
Diseases Childhood Cancer
Details This program provides financial assistance to families of children with cancer who are being treated at Hasbro Children's Hospital in Providence, Rhode Island to help cover the costs of meals, parking, home expenses including utility bills, medication, insurance co-pays and some travel expenses.
Eligibility Guidelines Must have a child diagnosed with cancer who is receiving treatment at Hasbro Children's Hospital in Providence.
How To Apply Contact the program directly to apply for assistance.
Area of Service Rhode Island

Childhood Cancer

Program Name Brittany Millar Foundation
Program Address PO Box 3047
Middletwon, NY 10940
Phone Number 845-344-3946
Fax Number 845-342-5820
Email info@brittanymiller.org
Diseases Childhood Cancer
Details This program will assist families with the hidden, non medical costs, invovled in having a child with cancer. The funds are used to defray travel, lodging, food and miscellaneous expenses associated with visits to hospitals or other treatment facilities in New York, New Jersey, Connecticut or elsewhere as is approved by the majority vote of the Board of Directors.
Eligibility Guidelines The family must live in the New York counties of Orange, Sullivan, Ulster, Dutchess, or Pike County PA and have a child diagnosised with cancer.
How To Apply Call the foundation to get more information and apply to the program.
Area of Service New York counties of Orange, Sullivan, Ulster, Dutchess, and Pike County of Pennsylvania.

Program Name Cancer Survivor's Medical Assistance Program
Program Address PO Box 792
Missouri City, TX 77549
Phone Number 281-437-7142
Fax Number 281-437-9568
Diseases Childhood Cancer
Details This grant is to reduce financial hardship on families by providing prosthetic limbs for young adults and children with cancer.
Eligibility Guidelines The applicant must be a resident of Texas, be a cancer survivor or currently diagnosed with cancer, the need for the prosthetic limb must be cancer related. The applicant will also be asked to write a 500 word essay on the topic “How has my experience with cancer impacted my life values and career goals?”
How To Apply Call the above number or go to the website. A letter from applicant’s doctor is also required.
Area of Service Texas

Program Name Cancer Survivor's Scholarship Program
Program Address PO Box 792
Missouri City, TX 77549
Phone Number 281-437-7142
Fax Number 281-437-9568
Diseases Childhood Cancer
Details This program awards four levels of scholarships to augment the expenses associated with the college educations of young cancer survivors.
Eligibility Guidelines The applicant must be a cancer survivor or currently diagnosed with cancer (but does not have to be receiving treatment to qualify), and be a resident of Texas. The applicant must also be enrolled or accepted into an accredited undergraduate or graduate program. The applicant will also be asked to write a 500 word essay on the topic “How has my experience with cancer impacted my life values and career goals?”
How To Apply Call the above number or go to the website. A letter from applicant’s doctor is required with the application. Also required is a copy of acceptance letter from the school or a letter of good standing from the registrar and two letter of recommendation from academic teachers.
Area of Service Texas

Program Name Candlelighters Childhood Cancer Family Alliance
Program Address 7502 Fondren Road, Suite 435
Houston, TX 77074
Phone Number 713-270-4700
Fax Number 713-270-9802
Diseases Childhood Cancer
Details This program offers practical assistance to families at the Anderson Cancer Center and the Texas Children's Cancer Center such as parking validations, gas cards, meal passes, grocery gift certificates,toiletry bags and up to $250.00 toward a funeral service to help ease the financial burden of diagnosis.
Eligibility Guidelines Must be a family of a child diagnosed with cancer and receiving treatment at the Texas Children's Cancer Center or The Anderson Cancer Center in Texas.
How To Apply Contact the program directly.

Program Name Candlelighters Childhood Cancer Foundation
Program Address National Office
PO Box 498
Kensington, MD 20895-0498
Phone Number 800-366-2223
301-962-3520
Fax Number 301-962-3521
Diseases Childhood Cancer
Details This national organziation has local affiliates who have a variety of programs to assist families in a variety of ways. The website has a list of the local affiliates and the contact information.
Eligibility Guidelines Each program is different in the type of assistance and the eligibilty requirements, but most ask that a social worker or hospital staff member contact the local chapter to start the process.
How To Apply See above.
Area of Service Nationwide

Program Name Candlelighters for Childhood Cancer of Michigan
Program Address 55527 Parkview
Shelby Twp, MI 48316
Phone Number 8586-484-9500
Fax Number
Email info@candlelightersofmichigan.org
Diseases Childhood Cancer
Details This program offers limited financial assistance to families with children who have cancer and live in Michigan. This support can include food and gas cards, hospital parking passes, hospital meal tickets, emergency fund for rent/mortgage/utilites, grocery certificates, coupons, phone cards.
Eligibility Guidelines The applicant must live in Michigan and be a child with cancer.
How To Apply Contact the program to get more information and to apply.
Area of Service Michigan

Program Name Candlelighters for Childhood Cancer of Southern Nevada
Program Address 3201 S Maryland Parkway
Suite 600
Las Vegas, NV 89109
Phone Number 702-737-1919
Diseases Childhood Cancer
Details This program has a variety of assistance programs to help families in Southern Nevada who have a child with cancer. These programs include: meal tickets to use at the hospital cafeteria, non-medical dislocation costs (rent, utilities, food etc) in times of medical or financial crisis, travel expenses (lodging, transportation and food) if the child has to travel out of state for treatments, local transportation, professional counseling, funeral costs, and camp registration and transportation for special camps.
Eligibility Guidelines The family must live in the programs area of Southern Nevada and have a child with cancer.
How To Apply Contact the program for more information and to apply.
Area of Service Southern Nevada

Program Name Candlelighters of Brevard Florida
Program Address PO Box 1353
Melbourne, FL 32902
Phone Number 321-728-5600
Diseases Childhood Cancer
Details This foundation has several programs to assist families living with childhood cancer in Brevard County. The Treatment Center Allotment Fund will reimburse for trips to treatment centers outside of Brevard County with a maximum of $300 per calendar month. The Emergency Assistance Program will help pay utility bills during crisis situations with a maximum of $300 a calendar month. The Prescription Drug Program will pay the out of pocket expenses for the prescription medications for the cancer patient and for antibiotics only for the patient's siblings. There is also a program to help with food expenses, as well as assistance finding places for the families to stay while the patient is getting treatment (Ronald McDonald Houses for example), and mental health counciling.
Eligibility Guidelines The family must live in Brevard County and have a child with cancer.
How To Apply Call or email the program for more information and how to apply.
Area of Service Brevard County, Florida

Program Name Candlelighters of Central Arkansas
Program Address 1805 Dorado Beach Dr.
Little Rock, AR 72212
Phone Number 501-223-9615
Diseases Childhood Cancer
Details This program can provide up to $500 annually to help with basic living expenses such as rent/mortgage, utilities, car repairs, travel costs, food and lodging related to treatment or doctor visits, pharmacy expenses, or funeral expenses.
Eligibility Guidelines The patient must be under the age of 21, living in or receiving treatment in Arkansas, and being treated for or been diagnosed with, cancer.
How To Apply The application is available on the website, or call the foundation to get an application sent. The completed application must be sent back with a signature of the child’s social worker or doctor.
Area of Service Arkansas

Program Name Children's Cancer Fund of New Mexico
Program Address 112 14th Street
Albuquerque, NM 87102
Phone Number 505-243-3618
Fax Number 505-243-1490
Diseases Any form of Cancer
Web Site No link available.
Details This program provides financial and other assistance to families with children who are living with and fighting cancer. Assistance includes, but is not limited to, help with mortgage payments, rent, utilities, gasoline, car payments, car repairs, grocery vouchers, wigs and recreational opportunities.
Eligibility Guidelines Must be a family of a child living with and/or fighting cancer who resides in New Mexico.
How To Apply Contact the program directly
Area of Service New Mexico

Program Name Children's Chance
Program Address PO Box 7453
609 Sims Ave
Columbia, SC 29202
Phone Number 803-254-5996
Fax Number 803-254-5997
Diseases Childhood Cancer
Details This program helps children and their families living in South Carolina with financial assistance for non-medical needs, including paying mortgage bills, electric bills, and other non-medical, everyday expenses.
Eligibility Guidelines The child must be 0-18 years old, diagnosised with cancer and living in South Carolina.
How To Apply Contact the program more information and to apply.
Area of Service South Carolina

Program Name Clayton Dabney Foundation for Kids with Cancer
Program Address 8150 N. Central Expressway
Suite 795
Dallas, TX 75206
Phone Number 214-361-2600
Fax Number 214-750-7011
Diseases Childhood Cancer
Details This fund provides financial assistance to families with children in the last stages of terminal cancer. The assistance is designed to make the child's last days more comfortable or to 'grant a wish.' Past grants have included assistance with rent, air conditioners, paying bills, work relief for the parents as well as gifts/trips for the child. There is a general limit of $2,000 cap per family.
Eligibility Guidelines Must be the family with a child, under the age of 21 in the last stages of terminal cancer.
How To Apply Families who wish to apply must be referred by a caseworker, child life specialist, nurse, doctor, hospital, hospice care, social worker or volunteer group. The referring person/organization must validate the families financial need. The referring person can fill out the application on line or fill it out and fax it back. A medical authorization from the child's primary physician must be attached to the application.
Area of Service National

Program Name Community Cancer Network
Program Address PO Box 4499
Lafayette, IN 47903
Phone Number 888-523-2261
765-446-5220
Email mbond@communitycancernetwork.org
Diseases Cancer
Details This program provides financial assistance for housing, utilities, pharmacy, communications and transport; Groceries, hot meals and nutritional support; Transportation to and from treatment; Cosmetic assistance for wigs, makeup, and other appearance articles and other services to cancer patients in treatment who live in the Indiana service area.
Eligibility Guidelines Applicants must be in treatment for cancer and live in one of the eleven counties serviced by the program.
How To Apply Contact the program by telephone to apply for assistance.
Area of Service Eleven Mid-Northern Indiana Counties

Program Name Family House
Program Address 50 Irving St.
1234 10th Avenue
San Francisco, CA 94122
Phone Number 415-476-8321
Diseases Childhood Cancer, Children with Life Threatening Illnesses, Children with Serious Medical Problems.
Details This program serves as a home away from home, at no cost, for families of seriously ill children being treated at the University of California San Francisco Children's Hospital for Cancer and other Serious Illness by providing room and board including kitchens, libraries, playrooms and laundry facilities.
Eligibility Guidelines Families of seriously ill children being treated at the University of California San Francisco Children's Hospital for Cancer or other serious illness. Must live a minimum distance of 50 miles away from San Francisco.
How To Apply Contact the UCSF Pediatric Social Work Office at (415) 353-2655.
Area of Service National

Program Name Foundation for Children with Cancer
Program Address 12166 Old Big Bend
Suite 202
St. Louis, MO 63122
Phone Number 314-822-2265
Fax Number 314-822-3720
Email info@childrenwithcancer.org
Diseases Childhood Cancer
Details This foundation will assist families who have a child under the age of 18 who has cancer. The financial assistance is for non-medical related expenses such as mortgage/rent payments, utility payments, insurance and transportation costs. As funding permits, patient/family is eligible for funds through treatment and one year after.
Eligibility Guidelines The patient must have a social security number and a diagnosis of cancer given before 18th birthday.
How To Apply A social worker must work as the contact between the family and the foundation. Social workers can download the application from the website.
Area of Service National

Program Name GlaxoSmithKline Hope for Families Fund/Children's Hospital of Philadelphia
Program Address 34th Street and Civic Center Boulevard
Philadelphia, PA 19104
Phone Number 267-426-6071
215-590-1000
Fax Number unavailable
Email mooreal@email.chop.edu
Diseases Relapsed Cancers
Details This fund will provide financial assistance to families of children being treated at Children's Hospital of Philadelphia for relapsed cancers to help with the costs of travel expenses including gas, plane tickets, taxi fares, and provide food vouchers, hotels and other necessary travel expenditures for the patient and a parent or family member.
Eligibility Guidelines Applicants must have a child being treated for relapsed cancers at Children's Hospital of Philadelphia and demonstrate a financial need.
How To Apply Contact the program directly to apply for assistance
Area of Service National

Program Name Hawaii Children's Cancer Foundation
Program Address 1814 Liliha Street
Honolulu, HI 96817
Phone Number 808-528-5161
Fax Number 808-521-4689
Diseases Childhood Cancer
Details This program provides direct financial assistance to the families of children who have been diagnosed with cancer and are receiving cancer treatment in Hawaii. The program will grant up to $4,000 for the first year of treatment and up to $2,000 for subsequent years of treatment to cover the costs of treatment bills, travel to treatment, medical supplies, medications and other expenses.
Eligibility Guidelines Children with cancer or who have had cancer and is receiving cancer treatment in Hawaii.
How To Apply Complete a "Family Assistance Application" from the programs website or contact the program directly.
Area of Service Hawaii

Program Name Little Star Foundation
Program Address 256 Rancho Milagro Way
Hesperus, CO 81326
Phone Number 800-543-6565
Diseases Children with Cancer, Children with Life Threatening Illnesses, Children with Serious Medical Problems.
Details This program provides long term care, educational, medical and financial support, as well as the distribution of medical supplies, equipment, food, clothing and educational supplies to children with cancer and other diseases.
Eligibility Guidelines Families of children diagnosed with cancer or other serious illness.
How To Apply Contact the program directly, or visit the program website for more information.
Area of Service National

Program Name Locks Of Love
Program Address 2925 10th Avenue N
Suite 102
Lake Worth, FL 33461
Phone Number 561-963-1677
888-896-1588
Fax Number 561-963-9914
Email info@locksoflove.org
Diseases Serious Childhood Disease, Childhood Cancer, Alopecia Areata, Hair Loss
Details This program provides high quality hair prosthetics to financially disadvantaged children in the United States and Canada who are under age 18 and living with long-term medical hair loss from any diagnosis. The retail value of the hair prosthetics is generally between $3,500 to $6,000. This program will also provide synthetic hairpieces to children living with short term hair loss.
Eligibility Guidelines Must be a resident of the United States or Canada, under age 18, living with long-term medical hair loss and meet financial eligibility guidelines as determined by the program.
How To Apply Contact the program directly, or visit the program website and complete an application.
Area of Service National

Program Name National Childrens Cancer Society
Program Address 1015 Locust
Suite 600
St. Louis, MO 63101
Phone Number 800-5-FAMILY
314-241-1600
Fax Number 314-241-6949
Email krudd@children-cancer.org
Diseases Childhood Cancer
Details This program helps both with medical expenses and non medical expenses.
Eligibility Guidelines The child must be a US resident under the age of 18. The family must have less than $5,000 in liquid assets to apply.
How To Apply Call the above number to get an application or apply on line.
Area of Service Nationwide.

Program Name Parents Against Cancer
Program Address 3479 Cahuenga Blvd W
Los Angeles, CA 90068
Phone Number 800-269-4186
323-850-7901
Fax Number 323-850-7914
Diseases Childhood Cancer
Details This program provides financial support to families of children who have been diagnosed and are receiving treatment for cancer in Southern California. Support is provided in the form of grocery vouchers, phone cards, transportation assistance and holiday food baskets. Financial assistance is also available specifically for patients receiving treatment at Children's Hospital Los Angeles for meal coupons and parking vouchers.
Eligibility Guidelines Must be the family of a child living with cancer, 18 yrs of age and living in Southern California.
How To Apply Contact the program directly or visit the program website.
Area of Service Southern California

Program Name The Cure For Our Children Foundation Take My Hand Program
Program Address
Hawthorne, CA
Phone Number 310-322-6046
Fax Number 310-454-9592
Diseases Cancer and other life threatening diseases
Details This program provides financial support to families with children who have cancer and other life threatening diseases. This support includes, but is not limited to financial support from the programs individual contribution fund and laptop computers on loan from the foundation to communicate with family members during treatment far away.
Eligibility Guidelines Nust be the family of a child with cancer or other life threatening disease
How To Apply Contact the program by phone, or use on-line application provided on the program website.
Area of Service National

Cancer of Extremities

Name Cancer Fund Of America, Inc.
Program Address 2901 Breezewood Lane
Knoxville, TN 37921
Phone Number 800-578-5284
Diseases Any form of Cancer
Details This program provides supplies and equipment to cancer patients free of charge including Liquid Nutritional Supplements and Vitamins, Adult Diapers, Bed Pads, and Exam Gloves, Fans and Seasonal Gift Boxes, Crutches, Lotions, and Ointments, Food Items and Various Medical Supplies and Non-Precription Medicine, Toys, Clothing, and Hygiene Kits.
Eligibility Guidelines Cancer patient with a qualifying need. Contact the program directly for further information on eligibility guidelines.
How To Apply Download the application to be completed by the patient and health care professional and send it back to the program.
Area of Service National

Breast Cancer

Program Name Breast and Cervical Cancer Treatment Program Of Arizona
Program Address 1201 E Washington St
Phoenix, AZ 85034
Phone Number 800-528-0142
Diseases Breast Cancer, Cervical Cancer
Details This program will provide health care to women who are diagnosised with breast or cervical cancer who have no insurance who live in Arizona.
Eligibility Guidelines The applicant must be under the age of 65, a resident of Arizona, and a US citizen or qualified immigrant. The applicant must also have no health care coverage or Medicaid and have a diagnosis of breast or cervical cancer.
How To Apply The application is available on the website or call the above number. The same The same application is used for all the health care assistance programs, AHCCS (Arizona Health Care Cost Containment System.) The application is 11 pages, but four are kept for the family records. Proof of income, residency, and assets are required with the completed application.
Area of Service Arizona

Program Name HealthWell Foundation
Program Address P.O Box 4133
Gaithersburg, MD 20885-
Phone Number 800-675-8416
Fax Number 800-282-7692
Diseases Acute Porphyrias, Age-Related Macular Degeneration, Anemia associated with Chronic Renal Insuffiency or Chronic Renal Failure, Ankylosing Spondylitis, Asthma, Moderate to Severe Breast Cancer, Carcinoid Tumors and Associated Symptoms, Chemotherapy Induced Anemia/Chemotherapy Induced Neutropenia, Idiopathic Thrombocytopenia Purpura (ITP), Colorectal Carcinoma, Cutaneous T-Cell Lymphoma, Head Cancer, Neck Cancer, Hodgkin's Disease, Immunosuppressive Treatment for Solid Organ Transplant Recipients, Iron Overload as a Result of Blood Transfusions, Multiple Myeloma, Myelodysplastic Syndromes, Non-Hodgkin's Lymphoma, Non-Small Cell Lung Cancer, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Secondary Hyperparathyroidism, Wilms' Tumor
Details This program helps pay for medical expenses including: medications, copayments, insurance premiums and other out-of-pocket healthcare costs. If accepted into the program, the patient is covered for up to one year. Accepted patients must submit invoices or receipts to reveice monetary awards. The foundation typically sends awards directly to the insurer, pharmacy, physician, or other provider. However, in some cases it may send awards directly to patients to reimburse them for expenses they must pay themselves.
Eligibility Guidelines Individuals covered by private insurance, employer-sponsored plans, Medicare or Medicaid may be eligible.The families income must be at or below 400% of the Federal Poverty Level, and state cost of living is also taken into account.
How To Apply Call the above number to get an application or apply on line.
Area of Service National

Program Name Patient Access Network Foundation
Program Address P.O. Box 221858
Charlotte, NC 28222-
Phone Number 866-316-7263
Fax Number 866-316-7261
Diseases Age Related Macular Degeneration, Anemia, Ankylosing Spondylitis, Breast Cancer, Colorectal Cancer, Crohn's Disease, Cutaneous T-Cell Lymphoma, Cystic Fibrosis, Gaucher's Disease, Growth Hormone Deficiency, Multiple Myeloma, Multiple Sclerosis, Myelodysplastic Syndrome, Non-Hodgkin's Lymphoma, Oncology Cytoprotection, Pancreatic Cancer, Plaque Psoriasis, Rheumatoid Arthritis , Respiratory Syncytial Virus
Details This program helps pay for medical expenses including: medications, co-payments, insurance premiums and other out of pocket health care costs.
Each disease has it's own application.
Eligibility Guidelines Individuals must be U.S. residents and meet certain financial, medical and insurance criteria as set by the Foundation's board of directors.
How To Apply Call the above number to get an application or apply on line.
Area of Service Nationwide

Program Name Sense of Security
Program Address PO Box 6098
Broomfield, CO 80021
Phone Number 303-669-3113
866-736-3113
Email info@senseofsecurity.org
Diseases Breast Cancer
Details This foundation has 4 different financial assistance programs for patients with breast cancer.
1. Sustained Assistance Program can fund the following expenses while you are in qualified treatments for breast cancer: mortgage or rent, medical insurance premiums, transportation costs, child care, utilities, and food and groceries. The monthly cap is $1,000 and the maxium duration is 12 months.
2. Emergency Fund is a one time aid program for up to $250 for an emergency situation such as eviction, repossession or shutoff notices.
3. Transportation Fund is another one time aid for up to $250 to provide gas, car repair, car payment, or insurance payment or renewal.
4. Household Fund is another one time aid program for up to $250 to provide groceries or household items.
Eligibility Guidelines The applicant must be a resident of Colorado, and must be receiving a qualifying treatment for or recovering from a qualifying surgery after a diagnosis of breast cancer. Applicants can be in any phase of a qualifying treatment for breast cancer or must be within two months of a qualifying breast cancer surgery. Applicants must also have exhausted all other forms assistance. There are also financial criteria for the programs, contact the foundation for more information.
How To Apply There are two applications, one for The Sustained Assistance Program, and one for the other three programs. Both are available on the website, or call the program for more information. Proof of residency, medical state and financial situation is required with the application.
Area of Service Colorado

Colorectal and Kidney- Cancer

Program Name Colorectal Care Line Financial Aid Fund
Program Address 700 Thimble Shoals Blvd
Suited 101
Newport News, VA 23606
Phone Number 866-657-8634
Fax Number 757-952-2031
Diseases Colorectal Cancer
Details The fund provides financial assistance through a small grant program for Colorectal Cancer patients in need of debt crisis assistance. Financial assistance in the amount of $200.00 is available to Colorectal Cancer patients with specific treatment related expenses like temporary housing, transportation to and from treatment, childcare necessitated by treatment and food costs.
Eligibility Guidelines Applicants must have a diagnosis and be receiving treatment for Colorectal Cancer and have a family income less than $75,000.00 annually.
How To Apply Applications are completed by a Colorectal CareLine Financial Aid Fund Counselor via telephone. The program accepts calls Monday-Friday from 8:30 AM EST to 5:00 PM EST. Patients must provide a verification of diagnosis and income as well as a documented need for financial assistance.
Area of Service National

Lung Cancer
Also see above programs that cover any type of Cancer

Pancreas Cancer
Also see all programs listed above that cover any type of cancer

Program Name Hirshberg Foundation
Program Address 275 Seventh Avenue
New York, NY 10001
Phone Number 212-712-8080
800-813-4673
Fax Number 212-712-8495
Diseases Pancreatic Cancer
Details This program helps with medical procedures, prescription medications, and transportation to and from doctor's office, hospital, treatment center or support group, up to $500 annually.
Eligibility Guidelines The patient must have pancreatic cancer and liquid assets at or below $15,000 for a family, $12,000 for a couple or $9,000.
How To Apply Call the above number to get more information and request an application.
Area of Service This program is nationwide.

Prostate Cancer

Program Address 700 Thimble Shoals Blvd
Suite 201
Newport, VA 23606
Phone Number 866-512-3861
Diseases Breast, Lung, Prostate, Kidney, Colon and Pancreatic cancers, Sarcomas, Lymphoma, Macular Degeneration, Low Blood counts due to Chemotherapy, Diabetes, and Rheumatoid Arthritis, Psoriatic Arthritis and Crohn's Disease.
Details Counselors assist patients throughout the entire application process, screening for eligibility by collecting financial and medical information from everyone who calls to apply for the Program.
Eligibility Guidelines This is a co-pay assistance program, the applicant must have insurance. The applicant must also be a US citizen.
How To Apply Call the above number to get more information and request an application.
Area of Service Nationwide

Program Name IMPACT
Program Address PO Box 957180
Los Angeles, CA 90095
Phone Number 800-409-8252
Fax Number 310-794-6789
Email info@california-impact.org
Diseases Prostate Cancer
Details The program provides free treatment for one to accepted patients who have prostrate cancer. This treatment can include; radical prostratectomy, external beam radiation therapy, hormone therapy, watchful waiting, brachytherapy and chemotherapy. The program also provides help in finding a doctor or hospital to receive treatment, and short term counseling.
Eligibility Guidelines The patient must be a resident of California, over the age of 18, have little or no health insurance and an income between 100% and 200% of the Federal Poverty Level. The patient must also have a diagnosis of prostrate cancer or have an abnormal DRE or elevated PSA.
How To Apply Call the foundation for more information and to enroll.
Area of Service California

Program Name Patient Advocate Foundation (PAF) Co-Pay Relief Program
Program Address 700 Thimble Shoals Boulevard
Newport News, VA 23606
Phone Number 866-512-3861
757-952-0118
Fax Number 757-952-0119
Details This program provides direct financial support to insured patients for co-payments, including Medicare Part D beneficiaries, who must financially and medically qualify to access pharmaceutical co-payment assistance. The program currently assists Patients being treated for breast, lung, prostate, kidney, colon, pancreatic, head/neck cancers, malignant brain tumor, sarcoma, diabetes, multiple myeloma, myelodsyplastic syndrome (and other pre-leukemia diseases), osteoporosis, pain, hepatitis C, rheumatoid arthritis, selected autoimmune disorders and CIA/CIN.
Eligibility Guidelines Applicants must be being treated for one of the program covered conditions and demonstrate a financial need.
How To Apply Contact the program directly or visit the program website to begin the application process
Area of Service National

Carcinoid Tumors

Program Name HealthWell Foundation
Program Address P.O Box 4133
Gaithersburg, MD 20885-
Phone Number 800-675-8416
Fax Number 800-282-7692
Diseases Acute Porphyrias, Age-Related Macular Degeneration, Anemia associated with Chronic Renal Insuffiency or Chronic Renal Failure, Ankylosing Spondylitis, Asthma, Moderate to Severe Breast Cancer, Carcinoid Tumors and Associated Symptoms, Chemotherapy Induced Anemia/Chemotherapy Induced Neutropenia, Idiopathic Thrombocytopenia Purpura (ITP), Colorectal Carcinoma, Cutaneous T-Cell Lymphoma, Head Cancer, Neck Cancer, Hodgkin's Disease, Immunosuppressive Treatment for Solid Organ Transplant Recipients, Iron Overload as a Result of Blood Transfusions, Multiple Myeloma, Myelodysplastic Syndromes, Non-Hodgkin's Lymphoma, Non-Small Cell Lung Cancer, Psoriasis, Psoriatic Arthritis, Rheumatoid Arthritis, Secondary Hyperparathyroidism, Wilms' Tumor
Details This program helps pay for medical expenses including: medications, copayments, insurance premiums and other out-of-pocket healthcare costs. If accepted into the program, the patient is covered for up to one year. Accepted patients must submit invoices or receipts to reveice monetary awards. The foundation typically sends awards directly to the insurer, pharmacy, physician, or other provider. However, in some cases it may send awards directly to patients to reimburse them for expenses they must pay themselves.
Eligibility Guidelines Individuals covered by private insurance, employer-sponsored plans, Medicare or Medicaid may be eligible.The famil ies income must be at or below 400% of the Federal Poverty Level, and state cost of living is also taken into account.
How To Apply Call the above number to get an application or apply on line.
Area of Service National

Cataracts

Program Name Mission Cataract USA
Phone Number 800-343-7265
Diseases Cataract
Web Site http://www.missioncataractusa.org/index.php?n=1&id=1
Details This program offers free cataract surgery to people of all ages who have no means to pay. Qualified applicants are referred to a participating doctor in their state.
Eligibility Guidelines To qualify for this free community service, applicants must have: poor vision, due to cataracts uncorrectable with glasses, which interferes with activities of daily living, no Medicare, Medicaid, or third party insurance coverage, and no other means to pay for cataract surgery.
How To Apply Contact the program directly by phone, or visit the website. You will be referred to a participating doctor in your state.
Area of Service National

Cerebral Palsy

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Web Site http://www.dhcs.ca.gov/services/ccs/Pages/default.aspx
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Program Name United Cerebral Palsy Association of Central Minnesota
Program Address 510 25th Ave N
St. Cloud, MN 56303
Phone Number 888-616-3726
320-253-0765
Email info@ucpcentralmn.org
Diseases Cerebral Palsy
Details This association has a financial assistance program to provide equipment for people with CP to increase their level of independence. This can include van lifts, adapted tricycles and communication devices. The fund does not approve grants for architechtural modifications, ongoing medical bills or computer systems.
Eligibility Guidelines The applicant must have CP, live in the serviced area and be in need.
How To Apply The application can be downloaded from the website. Supporting documentation is required.
Area of Service Minnesota counties of Benton, Stearns and Sherburne.

Name United Cerebral Palsy Association of Greater Chicago
Program Address 7550 W 183rd St
Tinely Park, IL 60477
Phone Number 708-444-8460
ext 231
Fax Number 708-429-3981
Email ggrill@ucpnet.org
Diseases Cerebral Palsy
Details The Ramp Up Foundation will assista eligible people with disabilities with the cost of needed home modifications.
Eligibility Guidelines The applicant must have CP, own their home and be unable to afforded the needed modifications.
How To Apply The application can downloaded from the website.
Area of Service Illinois

Program Name United Cerebral Palsy Association of Greater Indiana
Program Address 1915 W. 18th St.
Suite C
Indianapolis, IN 46202
Phone Number 800-723-7620
317-632-3561
Fax Number 317-632-3338
Email donnar@ucpaindy.org
Diseases Cerebral Palsy
Details This association has a program to provide financial assistance with the purchase of needed equipment for patients with Cerebral Palsy. This program can provide up to $1000 for home or vehicle adaptation. There is also a scholarships for high school seniors with CP as well as a fund for adaptive sport equipment.
Eligibility Guidelines The applicant must be in need.
How To Apply Contact the association to get more inforamation and to apply.

Program Name United Cerebral Palsy Association of San Diego
Program Address 8525 Gibbs Drive
Suite 100
San Diego, CA 92123
Phone Number 858-571-7803
800-748-6830
Fax Number 858-571-0919
Email ucp@ucpsd.org
Diseases Cerebral Palsy
Details
This association will provide small cash grants to members to assist with expenses related to the disability. The type of designated expenses that the fund can help provide for are: small specialized adaptive aides, diapers, specialized infant formulas, critical medications, inclusionary camps experiences, burial expenses and emergency respite.
Eligibility Guidelines The applicant must live in the Association area ( San Diego) and have CP or related disability.
How To Apply Call the association to get an application and more information.
Area of Service California (San Deigo)

Program Name United Cerebral Palsy Association of Southern Maryland
Program Address 211 Chinquapin Round Road
Annapolis, MD 21401
Phone Number 410-280-2003
Fax Number 410-269-5757
Email ucp@ucpsd.org
Diseases Cerebral Palsy
Details This association has finanical assistance to assist patients and families with CP gain or maintain independence. This assistance can include adaptive equipment, day care, home care, tuition, health services and transportation.
Eligibility Guidelines Unclear at this time.
How To Apply Contact the association to get gain more information and to apply.
Area of Service Maryland counties of Anne Arundel, Calvert, Charles and St. Mary.

Program Name United Cerebral Palsy Bellows Fund
Program Address Jack Schillinger, Administrator
1225 NE 93rd St
Miami Shores, FL 33138
Phone Number 305-757-8989
Fax Number 305-759-1305
Email jschill497@aol.com
Diseases Cerebral Palsy
Details This program provides funds to individuals with disabilities for assistive technology equipment or the repair of equipment. Applications will only be accepted through United Celebral Palsy Affiliate. Funds will only be sent to UCP Affiliates for the needed equipment.
Eligibility Guidelines Patients must be in need, and have a disability that requires assistive technology equipment.
How To Apply The application can be downloaded from the website, but must be filled out by an UCP Affiliate and sent into the foundation.
Area of Service National

Cervical Dystonia

Program Name NORD Cervical Dystonia Co-Payment Assistance Program
Program Address 55 Kenosia Ave
PO Box 1968
Danbury, CT 06813
Phone Number 800-999-6673
203-744-0100
Fax Number 203-798-2291
Email PatientAssistance@raredisease.org
Diseases Cervical Dystonia, Spasmodic Torticollis
Details This program will provide financial assistance to cover the costs of co-pays for approved medications used to treat Cervical Dystonia. Contact the program directly or visit the program website for a list of approved medications.
Eligibility Guidelines Uninsured or underinsured individuals living with Cervical Dystonia.
How To Apply Contact the program directly to apply for assistance.
Area of Service National

Chemo-Induced Nausea and Vomiting

Chemotherapy (Medications and Treatment)

Childhood Amputees

Program Name Disabled Children's Relief Fund
Program Address PO Box 89
Freeport, NY 11520
Diseases Children with Disabilities including: Blind, Deaf, Amputees, and children with Cerebral Palsy, Muscular Dystrophy, Spastic Quadriplegia, Encephalitis, Rheumatoid Arthritis, Spina Bifida, Down's Syndrome, and other disabilities.
Details This organizatoin provides disabled children with assistance to obtain wheelchairs, orthopedic braces, walkers, lifts, hearing aids, eyeglasses, medical equipment, physical therapy, and surgery.
Eligibility Guidelines This organization focuses on helping children throughout the US that do not have adequate health insurance. This could be a program of last resort.
How To Apply Call the organization between April and September to get an application.
Area of Service National

Childhood Blindness

Program Name Disabled Children's Relief Fund
Program Address PO Box 89
Freeport, NY 11520
Phone Number 516-377-1605
Diseases Children with Disabilities including: Blind, Deaf, Amputees, and children with Cerebral Palsy, Muscular Dystrophy, Spastic Quadriplegia, Encephalitis, Rheumatoid Arthritis, Spina Bifida, Down's Syndrome, and other disabilities.
Details This organizatoin provides disabled children with assistance to obtain wheelchairs, orthopedic braces, walkers, lifts, hearing aids, eyeglasses, medical equipment, physical therapy, and surgery.
Eligibility Guidelines This organization focuses on helping children throughout the US that do not have adequate health insurance. This could be a program of last resort.
How To Apply Call the organization between April and September to get an application.
Area of Service National

Childhood Blood Disorders

Program Address 4901 West Cypress Street
Tampa, FL 33607
Phone Number 813-367-5437
Fax Number 813-367-3865
Diseases Children with Cancer, Blood Disorders, Sickle Cell Anemia
Details This program assists families of children with cancer or blood disorders in the Tampa Bay or Boca Raton area with direct financial assistance. This assistance can include: Medications not covered by Insurance, CMS or Medicaid, Travel Expenses to and from the hospitals for families who live outside of the area, Food and Lodging for bone marrow transplant patients, Mortgage/Rent and Utility Payments, Funeral Expenses, Car Repair Expenses/Payments, Assistance with Groceries and additional needs as determined by pediatric staff.
Eligibility Guidelines The applicant must be a family with a child who has been diagnosed with cancer or a blood disorder who is in need.
How To Apply Patients should be referred to the foundation by social worker at the hospital.
Area of Service The Tampa Bay and Boca Raton areas.

Childhood Deafness

Program Name Miracle-Ear Children's Foundation
Program Address 5000 Cheshire Lane North
Minneapolis, MN 55446
Phone Number 800-234-5422
877-268-4264
Fax Number 763-268-4365
Diseases Children with Hearing Loss
Details This foundation provides hearing aids and services to children with hearing loss from low income families.
Eligibility Guidelines The child must be a US resident, 16 or younger and have a hearing loss that requires amplification. The family must have an audiogram and medical clearance dated within the last 6 months and an income between $20,000-45,000.
How To Apply Call the program or go to the website to request an application.
Area of Service National

Childhood Diabetes

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Program Name Children's Special Health Services of Montana
Program Address PO Box 202951
Helena, MT 59620
Phone Number 406-444-3622
800-762-9891
Fax Number 406-444-2750
Diseases Children with medical conditions requiring surgery, Children with treatable chronic conditions.
Details This program provides limited financial assistance for specialty care and therapies for children and youth with a physically disabling condition hat can be substantially improved or corrected with surgery, orthodontia or other treatment, or a medical condition, such as asthma or diabetes which is considered to be chronic and can be managed with treatment. Due to funding limitations, the program is unable to provide financial assistance for acute injuries, infections, or hospitalizations; mental health disorders or behavior problems; transportation; respite services; or educational services such as neuropsychological evaluations.
Eligibility Guidelines The child must be under the age of 19, have a family income at or below 200% of the Federal Poverty Level, be a Montana resident and is not eligible for either Medicaid or the Children's Health Insurances Plan (CHIP.)
How To Apply The application can be downloaded from the website or call the program to get more information. The completed application must be sent in with proof of income and a note from a physician explaining the medical condition.
Area of Service Montana

Childhood HIV

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Program Name The Bureau for Children with Medical Handicaps/Premium Payment Assistance Program
Program Address 1 West Winter Street, Second Floor
Delaware, OH 43015
Phone Number 740-368-1700
Diseases Conditions that are chronic, physically handicapping and can be treated including Diabetes, Cerebal Palsy, Scoliosis, Epilepsy, Cancer, Sickle Cell Disease, Hearing Loss, Spinal Injuries. Contact the program for a complete list of covered conditions.
Details This program will assist qualified families of children with specific physically handicapping and chronic conditions to pay for insurance premiums, including COBRA. Included in the list of covered diseases or conditions are Diabetes, Cerebal Palsy, Scoliosis, Epilepsy, Cancer, Sickle Cell Disease, Hearing Loss and Spinal Injuries. Contact the program directly or visit the program website for a complete list of covered conditions.
Eligibility Guidelines Child must be under the age of 21, be a resident of Ohio, have a medical handicap, be under the care of a BCMH-approved physician and meet the bureau's medical and financial guidelines. If the child remains eligible, services may be renewed each year until the child turns 21.
How To Apply Contact the program to apply for assistance. A medical application must be submitted by a BCMH approved physician.
Area of Service Ohio

Childhood Liver Disease

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Program Name National Foundation For Transplants
Program Address 5350 Poplar Ave
Memphis, TN 38119
Phone Number 800-489-3863
901-684-1697
Fax Number 901-684-1128
Diseases Organ Transplant
Details This program provides immediate, limited financial assistance to patients who have financial needs as a result of significant transplant-related costs not covered by private insurance or public assistance. This program has also partnered with a pharmaceutical company to provide free hotel stays to transplantg patients and their families.
Eligibility Guidelines Applicants in need of an organ transplant who live in the US legally and have a financial need as a result of significant transplant-related costs not covered by private insurance or public assistance.
How To Apply Contact the program directly to speak with a Patient Referral Counselor. A packet of information will be sent to begin the process.
Area of Service National

Children with Asthma

Children with Chronic Kidney Problems

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Children with Congenital Heart Disease

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Children with Craniofacial Conditions

Program Name Children's Craniofacial Association
Program Address 13140 Coit Rd
Suite 307
Dallas, TX 75240
Phone Number 800-535-3643
214-570-9099
Fax Number 214-570-8811
Diseases Children with Craniofacial Conditions
Details This association has an assistance program to help families who need to travel for a child's surgery. This fund can assist with food, travel, and lodging. The program will also help families find discounted hotel rates as well as donated airfare.
Eligibility Guidelines Unclear at this time.
How To Apply Contact the association to get more information and an application.
Area of Service National

Program Name FACES: The National Craniofacial Association
Program Address PO Box 11082
Chattanooga, TN 37401
Phone Number 800-332-2373
Email faces@faces-cranio.org
Diseases Children with Craniofacial Conditions
Details This foundation has a financial support program to aid with non-medical expenses needed to travel to a center for treatment.
Eligibility Guidelines Eligibilty is bases on financial and medical need.
How To Apply Contact the foundation for more information and to apply.
Area of Service National

Program Name Shriners Hospitals for Children
Program Address PO Box 31356
Tampa, FL 33621
Phone Number 800-237-5055
Diseases Orthopedic Conditions, Burn Injuries, Spinal Cord Rehabilitation, Cleft Lip, Palate Repair.
Web Site No link available.
Details Shriners Hospitals for Children are located throughout the United States and the hopsitals provided free care to children whom have a reasonable possibility that the child's condition can be helped by the the hospital.
Eligibility Guidelines The child must be under the age of 18. There are not any income limits.
How To Apply Call the program or go to the website to get an application.
Area of Service National

Program Name World Craniofacial Foundation
Program Address 7777 Forest Lane
Ste C-621
Dallas, TX 75251
Phone Number 800-533-3315
972-566-6669
Fax Number 972-533-3850
Diseases Head and face deformities in children (including trauma, degenerative diseases, tumors or birth-related.)
Details This foundation has an assistance program to assist families with children who are in need of correction for birth-related or acquired deformities of the head and face, including trauma, degenerative diseases and tumors.
Eligibility Guidelines Unclear at this time.
How To Apply Contact the foundation for more information and an application
Area of Service National

Children with Developmental Delays

Children with Disabilities

Program Name Challenged America
Program Address 15300 Ventura Blvd
Suite 414
Sherman Oaks, CA 91403
Phone Number 203-256-1011
Fax Number 203-256-9080
Diseases Children with Disabilities
Details This program will provide grants to disabled children for equipment. The grant can be up to $500.
Eligibility Guidelines The child must be under the age of 18, and have a disability.
How To Apply The application is available on line, or email the child's story.
Area of Service National

Program Name Disabled Children's Relief Fund
Program Address PO Box 89
Freeport, NY 11520
Phone Number 516-377-1605
Diseases Children with Disabilities including: Blind, Deaf, Amputees, and children with Cerebral Palsy, Muscular Dystrophy, Spastic Quadriplegia, Encephalitis, Rheumatoid Arthritis, Spina Bifida, Down's Syndrome, and other disabilities.
Details This organization provides disabled children with assistance to obtain wheelchairs, orthopedic braces, walkers, lifts, hearing aids, eyeglasses, medical equipment, physical therapy, and surgery.
Eligibility Guidelines This organization focuses on helping children throughout the US that do not have adequate health insurance. This could be a program of last resort.
How To Apply Call the organization between April and September to get an application.
Area of Service National

Program Name Kaitlin Marie Bell Foundation
Program Address 8966 Dolby Road
Seaford, DE 149973
Phone Number 302-629-5493
Fax Number 302-629-5556
Diseases Children with Disabilities
Details This foundation provides financial assistance, up to $500 to children who are unable to afford equipment and/or services that they need that are paid by insurance.
Eligibility Guidelines The child must be under the age of 21, have a disability and need the requested equipment or services.
How To Apply The application can be filled out on line, printed and then mailed back. Proof that all steps were taken to obtain the equipment and/or services, proof of income, and a recent letter from the child's doctor explaining medical necessity must be attached.
Area of Service National

Program Name Ohio Department of Health/Bureau of Children with Medical Handicaps (BCMH)
Program Address 1 West Winter Street, Second Floor
Delaware, OH 43015
Phone Number 740-368-1700
Diseases Medical Handicaps. Contact the program directly or visit the program website for a complete listing of eligible handicaps.
Details This program has four tiers that will find and help pay for medical services for children under 21 who are residents of Ohio and have a Medical Handicap. The Diagnostic Program will diagnose or rule out a condition and develop a plan for treatment. This portion of the program is available for up to three months. The Treatment Program helps to link families with specialty care providers and helps to pay for the medical care. These services can be used for up to one year. The Service Coordination Program helps families locate and coordinate services for their child. There is also a Premuim Payment Assistance Program that may assist qualified families to pay for their insurance premiums, including COBRA.
Eligibility Guidelines For the Diagnostic Program the child must be under 21 years of age, be a resident of the US and Ohio and have a possible medical handicap. There are no financial guidelines for this program. For the Treatment Program the child must be under 21 years of age, be a resident of Ohio, US resident, under the care of a BCMH approved physician, have an eligible handicap and be financially eligible. Medicaid and private insurance must be used before BCMH becomes a source of payment for this part of the program. The Service Coordination Program helps families locate and coordinate services for their child.
How To Apply Contact the Delaware General Health District at 740-368-1700
Area of Service Ohio

Program Name United Healthcare Children's Foundation
Program Address MN012-S286
PO BOX 41
Minneapolis, MN 55440
Phone Number 800-328-5979
952-992-4459
Fax Number Unavailable
Diseases Serious Childhood Illness, Children With Disabilities
Details This foundation provides grants of up to $5,000 to families to help pay for child health care services such as speech therapy, physical therapy, occupational therapy sessions, prescriptions, and medical equipment such as wheelchairs, orthotics and eyeglasses. The amount awarded to an individual within a 12-month period is limited to either $5,000 or 85% of the fund balance, whichever amount is less. Awards to any one individual are limited to a lifetime maximum of $7,500.
Eligibility Guidelines The applicant must be 16 years old or younger and live in the United States. The applicant must be covered by a commercial health benefit plan and limits for the requested service are either exceeded, or no coverage is available and/or the co payments are a serious financial burden on the family.
How To Apply Complete an on-line grant application on the programs website, or contact the program directly at 800.328.5979 ext 24459
Area of Service National

Children with Down's Syndrome

Children with Encephalitis

Children with Facial Deformities

Program Name Forward Face Family Assistance Fund
Program Address 317 East 34th St.
Suite 901A
New York, NY 10016
Phone Number 212-684-5860
Fax Number 212-684-5864
Email camille@forwardface.org
Diseases Apert, Cleft Lip & Palate, Craniosynostosis, Crouzon, Hemangiomas, Hemifacial Microsomia, Microtia, Pierre Robin Sequence, Treacher Collins, Cardiofaciocuteanous Syndrome, Carpenter Syndrome, Craniofrontonasal Dysplasia, Encephalocele, Goldenhar Syndrome, Hydrocephalus, Miller Syndrome, Mobius Syndrome, Nager Syndrome, Orbital Hypertelorism, Pfeiffer Syndrome, Roberts Syndrome, Stickler Syndrome, Velo-cardio-facial Syndrome, and Waarenburg Syndrome.
Details This fund will assist families who have children with facial deformities with certain medical expenses.
Eligibility Guidelines The family will need to provide financial documentation.
How To Apply Call the program to get more information and to apply
Area of Service National

Program Name Forward Face Nassau County Family Assistance Fund Application
Program Address 317 East 34th St.
Suite 901A
New York, NY 10016
Phone Number 212-684-5860
Fax Number 212-684-5864
Diseases Apert, Cleft Lip & Palate, Craniosynostosis, Crouzon, Hemangiomas, Hemifacial Microsomia, Microtia, Pierre Robin Sequence, Treacher Collins, Cardiofaciocuteanous Syndrome, Carpenter Syndrome, Craniofrontonasal Dysplasia, Encephalocele, Goldenhar Syndrome, Hydrocephalus, Miller Syndrome, Mobius Syndrome, Nager Syndrome, Orbital Hypertelorism, Pfeiffer Syndrome, Roberts Syndrome, Stickler Syndrome, Velo-cardio-facial Syndrome, and Waarenburg Syndrome.
Details This fund will assist families who have children with facial deformities with certain medical expenses. This program will only cover expenses not covered by insurance and does not cover medical costs.
Eligibility Guidelines The family will need to provide financial documentation and live in Nassau County.
How To Apply Call the program to get more information and to apply
Area of Service New York

Program Name Shriners Hospitals for Children
Program Address PO Box 31356
Tampa, FL 33621
Phone Number 800-237-5055
Diseases Orthopedic Conditions, Burn Injuries, Spinal Cord Rehabilitation, Cleft Lip, Palate Repair.
Web Site No link available.
Details Shriners Hospitals for Children are located throughout the United States and the hopsitals provided free care to children whom have a reasonable possibility that the child's condition can be helped by the the hospital.
Eligibility Guidelines The child must be under the age of 18. There are not any income limits.
How To Apply Call the program or go to the website to get an application.
Area of Service National

Children with Genetic Condition

Program Name Chai Lifeline
Program Address 151 West 30th Street
New York, NY 10001
Phone Number 877-CHAI-LIFE
212-465-1300
Fax Number 212-465-0949
Email unavailable
Diseases Childhood Life Threatening, Chronic or Genetic Disease
Web Site http://www.chailifeline.org/index.php
Details This program provides meal support, transportation to and from treatment and other services to families of children who are being treated for a life-threatening, chronic or genetic disease.
Eligibility Guidelines Applicants must be diagnosed with and receiving treatment for a life-threatening, chronic or genetic disease.
How To Apply The program has several regional and international offices. Visit the program website to locate an office near you or contact the international office using the number above to be directed accordingly.
Area of Service National

Children with Head Injuries

Children with Hearing Loss

Children with Life-Threatening Illnesses

Program Name Alpha-1 Kids
Program Address 4600 Keswick Road
Baltimore, MD 21210
Email info@alpha1kids,org
Diseases Alpha-1-antitrypsin deficiency
Details This program provides a financial grant in the amount of $2500 to transplant patients and their families to help pay for the cost of food, bills, housing, travel expenses and any other need to help make the process, usually away from home, easier on the families.
Eligibility Guidelines Liver transplant patients and their families.
How To Apply Contact the program directly to apply, or visit the program website for more information.
Area of Service National

Program Name Andre Sobel River of Life Foundation
Program Address 8899 Beverly Blvd
Suite 111
Los Angeles, CA 90048,
Phone Number 310-276-7111
Diseases Life threatening illness
Details This foundation provides financial assistance to single parents of children with life threatening illnesses to cover the costs of a wide range of expenses from foods, utilities and clothing to gasoline, car repair and housing. The foundation also offers the Andre Sobel Award in the amount of $5000.00 to a young cancer survivor.
Eligibility Guidelines Single parent of a child under 21 yrs of age with a life threatening illness who resides in the United States.
How To Apply Patients and families must be submitted to the foundation by a participating medical facility.
Area of Service National

Program Name Aubrey Rose Hollenkamp Children's Trust Foundation
Program Address 4480 Oakville Drive
Cincinnati, OH 45211
Email nancy@aubreyrose.org
Diseases Seriously Ill Children
Details This foundation provides grants to assist with medical bills for families with seriously ill children. The grant can only be used for unpaid medical bills. The deciding committee meets four times a year (March, June, September and December) and the applications are due the 1st of the month before.
Eligibility Guidelines The family must have unpaid medical bills related to a seriously ill child.
How To Apply The application can be downloaded from the webiste.
Area of Service National

Program Name Chai Lifeline
Program Address 151 West 30th Street
New York, NY 10001
Phone Number 877-CHAI-LIFE
212-465-1300
Fax Number 212-465-0949
Email unavailable
Diseases Childhood Life Threatening, Chronic or Genetic Disease
Eligibility Guidelines Applicants must be diagnosed with and receiving treatment for a life-threatening, chronic or genetic disease.
How To Apply The program has several regional and international offices. Visit the program website to locate an office near you or contact the international office using the number above to be directed accordingly.
Area of Service National

Program Name Fisher House
Program Address 7323 West Highway 90, Suite 206
San Antonio, TX 78227
Phone Number 210- 673-7500
Fax Number 210-673-7579
Diseases Serious Illness, Life Threatening Diseases, Children with Life Threatening Diseases, Children with Serious Medical Problems
Details This program is a home-away-from-home, at no cost, for the families of seriously ill or injured patients receiving treatment at Wilford Hall Medical Center in San Antonio, Texas. The three facilities have 25 fully-furnished bedrooms, most with private baths. The houses have well-stocked community kitchens, and spacious dining and living areas. Features include in-room telephones and cable TV/VCR, laundry facilities, housekeeping services, and transportation to and from the medical center. A caring staff member is available around-the-clock to assist guests.
Eligibility Guidelines Service members, parents, spouses, other relatives, or anybody supporting seriously ill or injured inpatients at Wilford Hall are eligible to stay at the two Fisher Houses and the Fisher House Inn for Children.
How To Apply To apply to this program, call the Department of Social Work at 210-292-6294 or visit the website for further details.
Area of Service National

Program Name Friends of Karen, Inc
Program Address PO Box 190
118 Titicus
Purdys, NY 10578
Phone Number 914-227-4547
631-473-1768
Fax Number 914-277-4967
Email info@friendsofkaren.org
Diseases Children with a life-threatening illness
Details The Family Support Program provides case management and attempts of find resources. If need remains the foundation will provide direct financial assistance for medical care and other illness-related expenses, including - but not limited to - transportation to medical treatment including parking, meals for parents while a child is inpatient, home care needs, child care for siblings when parents have to be with their hospitalized child, health insurance and basic living expenses that become unmanageable due to lost wages as a result of the illness and the high cost of medical care. There is also the Bereavement Support Services which helps with the emotional and financial support.
Eligibility Guidelines The patient must be under the age of 21 and have been diagnosised with a life-threatening illness and live in one of the following area: Bronx, Brooklyn, Manhattan, Staten Island, Queen, Long Island (Nassau, Suffolk), Westchester, Rockland, Putnam, Dutchess, Sullivan, Orange and Ulster Counties, northern New Jersey (Bergen, Essex, Hudson, Passaic, Union), and Fairfield County, Connecticut.
How To Apply Contact the program for more information.
Area of Service The New York City Area (including parts of NJ and CT)

Program Name Healing The Children
Program Address 112 5th Ave
Hawthorne, NJ 07506
Phone Number 973-949-5034
Fax Number 973-949-5036
Email info@midlantic.org
Diseases Serious Childhood Illness
Details This program provides financial assistance, assistance with transportation to locations where specialized care is available, medical supplies, specialized medical equipment and/or prescription medicines and homeless families with toiletries, food, clothing, over-the-counter medical supplies and baby items. This program also acts as a referral agency for free services and sometimes as an advocate with insurance companies, doctors, hospitals and/or local and state health organizations.
Eligibility Guidelines Must be the family of a child with a serious illness. All applications are considered on a case by case basis.
How To Apply Contact the program directly to apply.
Area of Service National

Program Name Jessica's Hope Chest
Program Address JHC Applications
PO Box 774
Louisburg, NC 27549
Phone Number 919 497-000
Diseases Critically Ill Children
Web Site http://www.4jhc.org/
Details This organization helps families with critically ill children cover the cost of necessities which are not covered by priviate medical insurance or government assistance. These necessities can include trasportation to and from medical facilities, housing costs, the purchase of specialized equipment and formulas. The foundation also have a limited Monthly Grant Program.
Eligibility Guidelines The child must be under the age of 18 and be critically ill.
How To Apply Call, email or go to the website for more details and an application
Area of Service National

Program Name Kentucky Commission For Children With Special Health Care Needs
Program Address 982 Eastern Parkway
Louisville, KY 40217
Phone Number 800-232-1160
502-595-4459
Fax Number 502-595-4673
Email Michele.Sither@ky.gov
Diseases Serious Childhood Disease, Children with Serious Illness
Details This program provides assistance with medical care and medications for children ages 0-21 with certain health conditions. A partial list of covered diseases or conditions includes, but is not limited to: Severe Asthma, Cerebral Palsy, Hemophilia, Scoliosis, Cystic Fibrosis and Spina Bifida. For a complete list of covered diseases, contact the program or visit their website.
Eligibility Guidelines Applicants should be residents of Kentucky, under 21 years of age, have a condition that usually responds to medical treatment that is provided within the program and demonstrate a financial need.
How To Apply Contact the program directly to apply or visit the program website.
Area of Service Kentucky

Program Name Little Star Foundation
Program Address 256 Rancho Milagro Way
Hesperus, CO 81326
Phone Number 800-543-6565
Diseases Children with Cancer, Children with Life Threatening Illnesses, Children with Serious Medical Problems.
Web Site http://www.littlestar.org/index.html
Details This program provides long term care, educational, medical and financial support, as well as the distribution of medical supplies, equipment, food, clothing and educational supplies to children with cancer and other diseases.
Eligibility Guidelines Families of children diagnosed with cancer or other serious illness.
How To Apply Contact the program directly, or visit the program website for more information.
Area of Service National

Program Name The Cure For Our Children Foundation Take My Hand Program
Program Address
Hawthorne, CA
Phone Number 310-322-6046
Fax Number 310-454-9592
Diseases Cancer and other life threatening diseases
Web Site http://www.cureourchildren.org/takemyhand.htm
Details This program provides financial support to families with children who have cancer and other life threatening diseases. This support includes, but is not limited to financial support from the programs individual contribution fund and laptop computers on loan from the foundation to communicate with family members during treatment far away.
Eligibility Guidelines Nust be the family of a child with cancer or other life threatening disease
How To Apply Contact the program by phone, or use on-line application provided on the program website.
Area of Service National

Program Name The Tomorrow Fund
Program Address RI Hospital Campus
593 Eddy Street
Providence, RI 02903
Phone Number 401-444-8811
Fax Number 401-444-4542
Email bducharme@lifespan.org
Diseases Childhood Cancer
Web Site http://www.tomorrowfund.org/financial_assistance.htm
Details This program provides financial assistance to families of children with cancer who are being treated at Hasbro Children's Hospital in Providence, Rhode Island to help cover the costs of meals, parking, home expenses including utility bills, medication, insurance co-pays and some travel expenses.
Eligibility Guidelines Must have a child diagnosed with cancer who is receiving treatment at Hasbro Children's Hospital in Providence.
How To Apply Contact the program directly to apply for assistance.
Area of Service Rhode Island

Children with Malocclusion

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Children with Muscular Dystrophy

Children with Physical Deformities

Program Name Children' Special Health Care Services -Indiana State Department of Health
Program Address Indiana State Department of Health
2 north Meridian St
Indianapolis, In 46204
Phone Number 800-475-1355
317-233-1325
Diseases Childhood chronic, critcal conditions. (Can include apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias, chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.)
Web Site Go to Website
Details This is a supplemental program that helps Indiana families of children with serious, chronic medical conditions pay for treatment to treatment related to their child's condition.
Eligibility Guidelines The child must be aged newborn to 21 years old, a resident of Indiana and have an income at or below 250% of the Federal Poverty Level. The child must also have a severe medical conditions that have lasted (or are expected to last) at least two years, will produce disability or disfigurement or limits on function, require special diet or devices, or, would produce a chronic disabling physical condition if untreated. Some physical conditions that may qualify a child for services include: apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.
How To Apply Contact the local county Office of Family and Children, the local First Steps agencey or Riley Hospital. To complete an application the applicant will need the chld's birth certificate, proof of residence, social security number of the child, and proof of parent(s)/guardian(s) income.
Area of Service Indiana

Children with physically disabling conditions

Program Name Ohio Department of Health/Bureau of Children with Medical Handicaps (BCMH)
Program Address 1 West Winter Street, Second Floor
Delaware, OH 43015
Phone Number 740-368-1700
Diseases Medical Handicaps. Contact the program directly or visit the program website for a complete listing of eligible handicaps.
Web Site http://www.delawarehealth.org/bcmh.htm
Details This program has four tiers that will find and help pay for medical services for children under 21 who are residents of Ohio and have a Medical Handicap. The Diagnostic Program will diagnose or rule out a condition and develop a plan for treatment. This portion of the program is available for up to three months. The Treatment Program helps to link families with specialty care providers and helps to pay for the medical care. These services can be used for up to one year. The Service Coordination Program helps families locate and coordinate services for their child. There is also a Premuim Payment Assistance Program that may assist qualified families to pay for their insurance premiums, including COBRA.
Eligibility Guidelines For the Diagnostic Program the child must be under 21 years of age, be a resident of the US and Ohio and have a possible medical handicap. There are no financial guidelines for this program. For the Treatment Program the child must be under 21 years of age, be a resident of Ohio, US resident, under the care of a BCMH approved physician, have an eligible handicap and be financially eligible. Medicaid and private insurance must be used before BCMH becomes a source of payment for this part of the program. The Service Coordination Program helps families locate and coordinate services for their child.
How To Apply Contact the Delaware General Health District at 740-368-1700
Area of Service Ohio

Children with PKU

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Children with Rheumatoid Arthritis

Children with Serious Medical Problems

Program Name Aubrey Rose Hollenkamp Children's Trust Foundation
Program Address 4480 Oakville Drive
Cincinnati, OH 45211
Email nancy@aubreyrose.org
Diseases Seriously Ill Children
Web Site http://www.aubreyrose.org/
Details This foundation provides grants to assist with medical bills for families with seriously ill children. The grant can only be used for unpaid medical bills. The deciding committee meets four times a year (March, June, September and December) and the applications are due the 1st of the month before.
Eligibility Guidelines The family must have unpaid medical bills related to a seriously ill child.
How To Apply The application can be downloaded from the webiste.
Area of Service National

Program Address c/o Cerner Corporation
2800 Rockcreek Parkway
Kansas City, MO 64117
Phone Number 816-201-1569
Fax Number 816-571-1569
Diseases Serious Childhood Medical Programs
Details Grants generally fit into three categories:

1) Clinical expenses: expenses associated with clinical procedures, treatment, medicine, therapy, prosthesis, etc.

2) Durable medical goods: wheelchairs, assistive technology equipment, specialized transportation and care devices

3) Displacement expenses: expenses associated with families of seriously ill children who must relocate during treatment
Eligibility Guidelines The child must be under the care of a pediatrician and have a specific need. There must be no existing financial net (such as Medicaid or private insurance) to cover the requested expenses. The case must be in a proactive stage. An application for debt reduction for expenses already incurred will not be considered for First Hand Foundation funding. All grant requests and associated application materials are due on the Friday before the first Wednesday of each month.
How To Apply Call the above number to get an application or apply on line.
Area of Service Nationwide

Program Name Jessica's Hope Chest
Program Address JHC Applications
PO Box 774
Louisburg, NC 27549
Phone Number 919 497-000
Diseases Critically Ill Children
Details This organization helps families with critically ill children cover the cost of necessities which are not covered by priviate medical insurance or government assistance. These necessities can include trasportation to and from medical facilities, housing costs, the purchase of specialized equipment and formulas. The foundation also have a limited Monthly Grant Program.
Eligibility Guidelines The child must be under the age of 18 and be critically ill.
How To Apply Call, email or go to the website for more details and an application
Area of Service National

Program Name Spare Key
Program Address 1380 Energy Lane
Sutie 203
St. Paul, MN 55108
Phone Number 651-457-2607
Email info@sparekey.org
Diseases Children with Serious Medical Problems.
Web Site http://www.sparekey.org/
Details This program will pay mortgage payments for accepted applicants not to exceed $1,500 for up to one year. The program will also pay second mortgages, but not association fees, rent, or payments on multiple properties.
Eligibility Guidelines The family of the child must be resident of Minnesota and a US citizen or legal alien. The family must also show that the the childs medical care has resulted in a demonstrated significant reduction of income or increase in expenses or the families income is below $38,200 (if they live within the 11 county metro area) or below $25,600 and live out-state. The child must have either a minimum of 21 days of inpatient hospital care within 90 days before assistance will be considered or 10 days inpatient and a minimum of 11 days of full time home nursing are.
How To Apply The application is available on the website, or call the above number to get the application sent out. The completed application must be sent back with a copy of a mortgage statement or written documentation from the lender.
Area of Service Minnesota

Program Name Wyoming Children's Special Health
Program Address 6101 N Yellowstone Rd.
Suite 420
Cheyenne, WY 82002
Phone Number 307-777-5413
307-777-7941
Fax Number 307-777-7215
Diseases Convulsive Disorders, Neurofibromatosis, Juvenile Idiopathis Arthritis, Cystic Fibrosis, Diabetes Mellitus Type I, Esotropia, Exotropia and Amblyopia, Autism Spectrum Disorder/Pervasive Developmental Delay, Global Developmental Delay, Osteogenesis Imperfecta, Retinopathy of Prematurity, Tympanostomy Tubes, Hemophilia and Variants, Cerebral Palsy
Web Site http://wdh.state.wy.us/familyhealth/csh/index.html
Details This is a program that provides financial assistance to families with children who have special health care needs in Wyoming. The program will pay for specialty medical care related to the approved/condition/diagnosis. There is up to $40,000 maxium annual coverage.
Eligibility Guidelines The child must be a Wyoming resident under the age of 19 and be suspected or known to have one of the medically eligibles (ie chronic illness or disability) The child can have insurance, KidCare, CHIP, Medicaid.
How To Apply To apply or get more information contact The Public Health Nurse (a list is available on the website.) The child's medical, education and family financial records are required when meeting with the Public Health Nurse.
Area of Service Wyoming

Children with Spastic Quadriplegia &
Children with Spina Bifida

Children with Spinal Cord Injuries

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Program Name Shriners Hospitals for Children
Program Address PO Box 31356
Tampa, FL 33621
Phone Number 800-237-5055
Diseases Orthopedic Conditions, Burn Injuries, Spinal Cord Rehabilitation, Cleft Lip, Palate Repair.
Web Site No link available.
Details Shriners Hospitals for Children are located throughout the United States and the hopsitals provided free care to children whom have a reasonable possibility that the child's condition can be helped by the the hospital.
Eligibility Guidelines The child must be under the age of 18. There are not any income limits.
How To Apply Call the program or go to the website to get an application.
Area of Service National

Children with Terminal Illinesses

Program Name American Cancer Society
Program Address 1599 Clifton Rd., NE
Atlanta, GA 30329-4251
Phone Number 800-ACS-2345
Diseases Any form of Cancer
Details Each local office of the American Cancer Society may have different programs to help with expenses related to cancer treatment, including transportation, medicine, medical supplies and lodging.
Eligibility Guidelines Not specified.
How To Apply Call the above number or go on-line to find a local chapter to get an application
Area of Service The local chapters administer the different programs

Program Name Kelly Ann Dolan Memorial Foundation
Program Address KADMF
PO Box 556
Ambler, PA 19002
Phone Number 215-643-0763
Fax Number 215-628-0266
Diseases Children with Chronic or Terminal Illness.
Details This program helps pay for non medical expenses not covered by insurance (Child care, travel related costs, education and support meetings, and cosmetic or hygiene products.)
Eligibility Guidelines All referrals must be made through a social worker, nurse, case worker or other healthcare provider. The child must have a diagnosed serious, chronic or critical illness, disability or condition currently requiring medical attention, though he or she does not need to be hospitalized at the time of the referral; further, the child must be medically involved enough that he or she is currently being followed by a healthcare provider who is informed about the child’s condition.
How To Apply Call the above number to get more information. The website has the Healthcare Provider Application for download.
Area of Service New Jersey, Pennsylvania, and Deleware.

Children with Thyroid Problems &
Children with Uncontrolled Seizures

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Chromosomal Disorders

Chronic Bronchitis

Chronic Disease – Debilitating or Life Threatening

Program Name Caring Voice Coalition
Program Address 8249 Meadowbridge Road
Mechanicsville, VA 23116
Phone Number 888-267-1440
804-427-6468
Fax Number
Email CVCInfo@caringvoice.org
Diseases Chronic, Serious illnesses
Web Site http://www.caringvoice.org/about.htm
Details There are three categories to the program. The Medicare Prescription Drug Assistance Program will help clients pay for medication while the client is in the Medicare Part D coverage gap. The Insurance Copayment Assistance program will help in paying copayments or coinsurance costs to the pharmacy.The Insurance Premium Assistance Program helps clients pay for insurance premiums.
Eligibility Guidelines The applicant must have a chronic illness supported by CVC, be taking an FDA approved drug for the treatment and have current health insurance that covers the medication. The applicant must also show a need for financial help.
How To Apply Call the program to request an application, or visit the program website for more information.
Area of Service National

Program Name Friends of Karen, Inc
Program Address PO Box 190
118 Titicus
Purdys, NY 10578
Phone Number 914-227-4547
631-473-1768
Fax Number 914-277-4967
Email info@friendsofkaren.org
Diseases Children with a life-threatening illness
Web Site http://www.friendsofkaren.org/index.asp
Details The Family Support Program provides case management and attempts of find resources. If need remains the foundation will provide direct financial assistance for medical care and other illness-related expenses, including - but not limited to - transportation to medical treatment including parking, meals for parents while a child is inpatient, home care needs, child care for siblings when parents have to be with their hospitalized child, health insurance and basic living expenses that become unmanageable due to lost wages as a result of the illness and the high cost of medical care. There is also the Bereavement Support Services which helps with the emotional and financial support.
Eligibility Guidelines The patient must be under the age of 21 and have been diagnosised with a life-threatening illness and live in one of the following area: Bronx, Brooklyn, Manhattan, Staten Island, Queen, Long Island (Nassau, Suffolk), Westchester, Rockland, Putnam, Dutchess, Sullivan, Orange and Ulster Counties, northern New Jersey (Bergen, Essex, Hudson, Passaic, Union), and Fairfield County, Connecticut.
How To Apply Contact the program for more information.
Area of Service The New York City Area (including parts of NJ and CT)

Program Name Patient Advocate Foundation
Program Address 700 Thimble Shoals Blvd
Suite 200
Newport, VA 23606
Phone Number 800-532-5274
Fax Number 757-873-8999
Email help@patientadvocate.org
Diseases Chronic, Debilitating or Life Threatening Disease
Web Site http://www.patientadvocate.org/
Details This program will help with every aspect of financial struggles due to illness. They will work with insurance, doctors, and hospitals to find assistance in paying for needed care. They will also help find ways to pay for any medical debt and/or cost of living issues brought on by the disease.
Eligibility Guidelines The patient must have a chronic, debilitating or life threatening disease.
How To Apply Call the above number to start the process.
Area of Service Nationwide.

Program Name Surgery on Sunday, Inc (SOS)
Program Address PO Box 498
Lexington, KY 40504
Phone Number 859-246-0046
Fax Number 859-246-1752
Diseases In need of surgery for illness or condition
Web Site http://www.surgeryonsunday.org/
Details This program helps people who are need of surgeries but can't afford them, who live in Kentucky. This is a referral based program, that works with clinics to give free surgeries and treatments to accepted applicants on Sunday a month.
Eligibility Guidelines The applicant must not qualify for Medicare or Medicaid and not afford health insurance.
How To Apply All applicants must be referred to the program by a participating organization. There is a list on the website of these organizations, or call the program to get more information.
Area of Service Kentucky

Chronic Childhood Illnesses

Program Name Andre Sobel River of Life Foundation
Program Address 8899 Beverly Blvd
Suite 111
Los Angeles, CA 90048,
Phone Number 310-276-7111
Diseases Life threatening illness
Web Site http://www.andreriveroflife.org/mission.html
Details This foundation provides financial assistance to single parents of children with life threatening illnesses to cover the costs of a wide range of expenses from foods, utilities and clothing to gasoline, car repair and housing. The foundation also offers the Andre Sobel Award in the amount of $5000.00 to a young cancer survivor.
Eligibility Guidelines Single parent of a child under 21 yrs of age with a life threatening illness who resides in the United States.
How To Apply Patients and families must be submitted to the foundation by a participating medical facility.
Area of Service National

Program Name Aubrey Rose Hollenkamp Children's Trust Foundation
Program Address 4480 Oakville Drive
Cincinnati, OH 45211
Email nancy@aubreyrose.org
Diseases Seriously Ill Children
Web Site http://www.aubreyrose.org/
Details This foundation provides grants to assist with medical bills for families with seriously ill children. The grant can only be used for unpaid medical bills. The deciding committee meets four times a year (March, June, September and December) and the applications are due the 1st of the month before.
Eligibility Guidelines The family must have unpaid medical bills related to a seriously ill child.
How To Apply The application can be downloaded from the webiste.
Area of Service National

Program Name Catastrophic Illness in Children Relief Fund
Program Address New Jersey Department of Human Services
PO Box 700
Trenton, NJ 80625
Phone Number 800-335-3863
609-292-0600
Email www.state.nj.us/humanservices/catill/email.htm
Diseases Children with cronic diseases
Web Site http://www.state.nj.us/humanservices/catill/cicrf1.htm
Details This fund helps families with ill children who can not afford the medical bills.
Eligibility Guidelines The child must under the age of 21 when the medical expenses were incurred and the family must live in New Jersery for at least 3 months immediately prior to the date of application. (Migrant workers may be eligible.) The family can be overwhelmed with medical expenses due to; lack of insurance or no dependent coverage, preexisting condition exclusion, expenses exceed max benefits allowed, or co-pays and expenses that are uncovered by insurance. In any prior consecutive 12 month period, dating back to 1998, eligible expenses must exceed 10% of the family's income.
How To Apply Call the Fund to get more information and to apply.
Area of Service New Jersey

Program Name Embrace Kids Foundation
Program Address 121 Somerset Street
The Edith and Martin Stein Building of Hope
New Brunswick, NJ 08901
Phone Number 732-247-5300
Diseases Chronic Illness
Web Site http://www.embracekids.org/emergency-financial-assistance
Details This program provides financial assistance to the families of chronically ill children to help pay the costs of rent, mortgage, utility bills, prescriptions, babysitters and transportatipon to and from medical appointments.
Eligibility Guidelines Must be a family of a child with a chronic illness.
How To Apply Contact the program directly.
Area of Service National

Program Name Godstock
Program Address PO Box 661
China Grove, NC 28023
Phone Number 704-857-7011
Fax Number 704-857-9856
Diseases Childhood Chronic Illness.
Web Site http://www.godstock.org/
Details This program will provide financial support to North Carolina residents with chroncially ill children for non medical bills.
Eligibility Guidelines The applicant must be between the ages of 0-19 and live in North Carolina.
How To Apply Email or call the program facilitator to get an application emailed, faxed or mailed out.
Area of Service This program assists people in North Carolina.

Program Name Kelly Ann Dolan Memorial Foundation
Program Address KADMF
PO Box 556
Ambler, PA 19002
Phone Number 215-643-0763
Fax Number 215-628-0266
Diseases Children with Chronic or Terminal Illness.
Web Site http://www.kadmf.org/
Details This program helps pay for non medical expenses not covered by insurance (Child care, travel related costs, education and support meetings, and cosmetic or hygiene products.)
Eligibility Guidelines All referrals must be made through a social worker, nurse, case worker or other healthcare provider. The child must have a diagnosed serious, chronic or critical illness, disability or condition currently requiring medical attention, though he or she does not need to be hospitalized at the time of the referral; further, the child must be medically involved enough that he or she is currently being followed by a healthcare provider who is informed about the child’s condition.
How To Apply Call the above number to get more information. The website has the Healthcare Provider Application for download.
Area of Service New Jersey, Pennsylvania, and Deleware.

Program Name The Bureau for Children with Medical Handicaps/Premium Payment Assistance Program
Program Address 1 West Winter Street, Second Floor
Delaware, OH 43015
Phone Number 740-368-1700
Diseases Conditions that are chronic, physically handicapping and can be treated including Diabetes, Cerebal Palsy, Scoliosis, Epilepsy, Cancer, Sickle Cell Disease, Hearing Loss, Spinal Injuries. Contact the program for a complete list of covered conditions.
Web Site http://www.delawarehealth.org/bcmh.htm
Details This program will assist qualified families of children with specific physically handicapping and chronic conditions to pay for insurance premiums, including COBRA. Included in the list of covered diseases or conditions are Diabetes, Cerebal Palsy, Scoliosis, Epilepsy, Cancer, Sickle Cell Disease, Hearing Loss and Spinal Injuries. Contact the program directly or visit the program website for a complete list of covered conditions.
Eligibility Guidelines Child must be under the age of 21, be a resident of Ohio, have a medical handicap, be under the care of a BCMH-approved physician and meet the bureau's medical and financial guidelines. If the child remains eligible, services may be renewed each year until the child turns 21.
How To Apply Contact the program to apply for assistance. A medical application must be submitted by a BCMH approved physician.
Area of Service Ohio

Chronic Kidney Disease

Program Name Children' Special Health Care Services -Indiana State Department of Health
Program Address Indiana State Department of Health
2 north Meridian St
Indianapolis, In 46204
Phone Number 800-475-1355
317-233-1325
Diseases Childhood chronic, critcal conditions. (Can include apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias, chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.)
Web Site http://www.in.gov/ai/errors/isdh_404.html
Details This is a supplemental program that helps Indiana families of children with serious, chronic medical conditions pay for treatment to treatment related to their child's condition.
Eligibility Guidelines The child must be aged newborn to 21 years old, a resident of Indiana and have an income at or below 250% of the Federal Poverty Level. The child must also have a severe medical conditions that have lasted (or are expected to last) at least two years, will produce disability or disfigurement or limits on function, require special diet or devices, or, would produce a chronic disabling physical condition if untreated. Some physical conditions that may qualify a child for services include: apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.
How To Apply Contact the local county Office of Family and Children, the local First Steps agencey or Riley Hospital. To complete an application the applicant will need the chld's birth certificate, proof of residence, social security number of the child, and proof of parent(s)/guardian(s) income.
Area of Service Indiana

Program Name National Kidney Foundation of the Virginias (Virginia)
Program Address 2601 Willard Rd
Suite 103
Richmond, VI 23294
Phone Number 888-543-6398
804-288-8342
Fax Number 804-282-7835
Email welcome@kidneyva.org
Diseases Chronic Kidney Disease, Chronic Urological Disease
Web Site http://www.kidneyva.org/index.html
Details This foundation has a grant to provide financial assistance to those affected by chronic kidney and/or urologic disease who live in the service area (most of Virginia and West Virginia) who experience unusual or unexpected expenses affecting the continuity of medical care.
Eligibility Guidelines The applicant must live in the area of service (most of Virginia and West Virginia), and have chronic kidney and/or urologic disease.
How To Apply The application can be downloaded from the website and should be filled out by a social worker, but the applicant must sign it as well.
Area of Service Virginia

Program Name National Kidney Foundation of the Virginias (West Virginia)
Program Address 2601 Willard Rd
Suite 13
Richmond, VA 23294
Phone Number 888-543-6398
804-288-8342
Fax Number 804-282-7835
Email welcome@kidneyva.org
Diseases Chronic Kidney Disease, Chronic Urological Disease
Web Site http://www.kidneyva.org/index.html
Details This foundation has a grant to provide financial assistance to those affected by chronic kidney and/or urologic disease who live in the service area (most of Virginia and West Virginia) who experience unusual or unexpected expenses affecting the continuity of medical care.
Eligibility Guidelines The applicant must live in the area of service (most of Virginia and West Virginia), and have chronic kidney and/or urologic disease.
How To Apply The application can be downloaded from the website and should be filled out by a social worker, but the applicant must sign it as well.
Area of Service West Virginia

Chronic Myelocytic Leukemia &
Chronic Myeloid Leukemia

Program Name Patient Services, Inc.
Program Address PO Box 1602
Midlothian, VA 23113
Phone Number 800-366-7741
Fax Number 804-744-5407
Diseases Alpha-1-Antitrypsin Deficiency, Bone Health, Chronic Myelocytic Leukemia, Gastrointestinal Stromal Tumors, IGF-1 (Insulin-like Growth Factor Deficiency), Hemophilia, MPS-1 Hurler/Scheie, Primary Immune Deficiency, Fabry Disease, Pompe, Severe Congenital Protein C Deficiency, Cystic Fibrosis associated with Pseudomonas Aeruginosa, Cutaneous T-Cell Lymphoma, Asthma (Moderate to Severe IgE-mediated Asthma)
Web Site http://www.uneedpsi.org/cms400min/index.aspx
Details This program assists persons with chronic medical illnesses in accessing health insurance and pharmacy co-payment assistance.
Eligibility Guidelines The patient must have insurance and be a US citizen.
How To Apply Call the above number to get more information and request an application.
Area of Service Nationwide

Chronic Pain

Program Name NORD Intrathecal Therapy for Pain Management Co-Payment Assistance Program
Program Address 55 Kenosia Ave
Danbury, CT 06813
Phone Number 888-774-2581
203-744-0100
Fax Number 203-798-2291
Email PatientAssistance@raredisease.org
Diseases Chronic Pain
Web Site http://www.rarediseases.org/programs/medication
Details This program will provide financial assistance to cover the costs of co-pays for Intrathecal Therapy for pain management.
Eligibility Guidelines Uninsured or underinsured individuals receiving Intrathecal Therapy for pain management.
How To Apply Contact the program directly to apply for assistance.
Area of Service National

Chronic Plaque Psoriasis

Program Name NORD CPP Premium/Co-Payment Assistance Program
Program Address 55 Kenosia Ave
Danbury, CT 06813
Phone Number 800-634-7207
203-744-0100
Fax Number 203-798-2291
Email PatientAssistance@raredisease.org
Diseases Plaque Psoriasis
Web Site http://www.rarediseases.org/programs/medication
Details This program will provide financial assistance to cover the costs of co-pays for approved medications used to treat Plaque Psoriasis. Contact the program directly or visit the program website for a list of approved medications.
Eligibility Guidelines Uninsured or underinsured individuals living with Plaque Psoriasis.
How To Apply Contact the program directly to apply for assistance
Area of Service National

Chronic Pulmonary Disease

Program Name Children' Special Health Care Services -Indiana State Department of Health
Program Address Indiana State Department of Health
2 north Meridian St
Indianapolis, In 46204
Phone Number 800-475-1355
317-233-1325
Diseases Childhood chronic, critcal conditions. (Can include apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias, chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.)
Web Site http://www.in.gov/ai/errors/isdh_404.html
Details This is a supplemental program that helps Indiana families of children with serious, chronic medical conditions pay for treatment to treatment related to their child's condition.
Eligibility Guidelines The child must be aged newborn to 21 years old, a resident of Indiana and have an income at or below 250% of the Federal Poverty Level. The child must also have a severe medical conditions that have lasted (or are expected to last) at least two years, will produce disability or disfigurement or limits on function, require special diet or devices, or, would produce a chronic disabling physical condition if untreated. Some physical conditions that may qualify a child for services include: apnea, arthritis, autism, severe asthma, cerebral palsy, chronic anemia, cleft lip and/or palate, congenital or acquired developmental deformities, congenital heart disease or arrhythmias chromosomal disorders, chronic pulmonary disease, cystic fibrosis (life time coverage), endocrine deficiencies, profound hearing loss, severe hemophilia hydrocephalus, inflamammatory bowel disease, inborn errors of metabolism, neuromuscular dysfunction, myelodyspasia or spinal cord dysfunction, oncologic disorders, renal disease, seizure disorder.
How To Apply Contact the local county Office of Family and Children, the local First Steps agencey or Riley Hospital. To complete an application the applicant will need the chld's birth certificate, proof of residence, social security number of the child, and proof of parent(s)/guardian(s) income.
Area of Service Indiana

Chronic Urologic Disease

Program Name National Kidney Foundation of the Virginias (West Virginia)
Program Address 2601 Willard Rd
Suite 13
Richmond, VA 23294
Phone Number 888-543-6398
804-288-8342
Fax Number 804-282-7835
Email welcome@kidneyva.org
Diseases Chronic Kidney Disease, Chronic Urological Disease
Details This foundation has a grant to provide financial assistance to those affected by chronic kidney and/or urologic disease who live in the service area (most of Virginia and West Virginia) who experience unusual or unexpected expenses affecting the continuity of medical care.
Eligibility Guidelines The applicant must live in the area of service (most of Virginia and West Virginia), and have chronic kidney and/or urologic disease.
How To Apply The application can be downloaded from the website and should be filled out by a social worker, but the applicant must sign it as well.
Area of Service West Virginia

Cleft Lip and Palate

Program Name California Children's Services
Program Address Contact is Through County CCS Office

Phone Number None
Diseases Conditions involving the Heart, Neoplasms, Disorders of the Blood, Endocrine, nutritional, and metabolic diseases, Disorders of the genito-urinary system, Disorders of the gastrointestinal system, Serious birth defects, Disorders of the sense organs, Disorders of the nervous system, Disorders of the musculoskeletal system and connective tissues, Severe disorders of the immune system, Disabling conditions or poisonings requiring intensive care or rehabilitation, Complications of premature birth requiring an intensive level of care, Disorders of the skin and subcutaneous tissue, Medically handicapping malocclusion
Details This is a program that treats children with certain physical limitations and chronic health conditions or dieases. The program can authorize and pay for specific medical services and equipment provided by approved specialists. These can include: doctor services, hospital and surgical care, physical therapy, occupational therapy, lab tests, x-rays, orthopedic appliances, medical equipment, medical case management, and/or referrals to other agencies.
Eligibility Guidelines The applicant must be under 21, a resident of California and have a family gross adjusted income of $40,000 or less, or the out-or-pocket medical expenses for a child who qualifies are expected to be more than 20% of the family income or the child has Healthy Families Coverage.
How To Apply The application is available on line. It must be completed and sent back to a county department of California Children's Services (there is a list on the website). Some of the programs are run by the California Department of Health Services.
Area of Service California

Program Name Foward Face Family Assistance Fund
Program Address 317 East 34th St.
Suite 901A
New York, NY 10016
Phone Number 212-684-5860
Fax Number 212-684-5864
Email camille@forwardface.org
Diseases Apert, Cleft Lip & Palate, Craniosynostosis, Crouzon, Hemangiomas, Hemifacial Microsomia, Microtia, Pierre Robin Sequence, Treacher Collins, Cardiofaciocuteanous Syndrome, Carpenter Syndrome, Craniofrontonasal Dysplasia, Encephalocele, Goldenhar Syndrome, Hydrocephalus, Miller Syndrome, Mobius Syndrome, Nager Syndrome, Orbital Hypertelorism, Pfeiffer Syndrome, Roberts Syndrome, Stickler Syndrome, Velo-cardio-facial Syndrome, and Waarenburg Syndrome.
Details This fund will assist families who have children with facial deformities with certain medical expenses.
Eligibility Guidelines The family will need to provide financial documentation.
How To Apply Call the program to get more information and to apply
Area of Service National

Program Name Foward Face Nassau County Family Assistance Fund Application
Program Address 317 East 34th St.
Suite 901A
New York, NY 10016
Phone Number 212-684-5860
Fax Number 212-684-5864
Diseases Apert, Cleft Lip & Palate, Craniosynostosis, Crouzon, Hemangiomas, Hemifacial Microsomia, Microtia, Pierre Robin Sequence, Treacher Collins, Cardiofaciocuteanous Syndrome, Carpenter Syndrome, Craniofrontonasal Dysplasia, Encephalocele, Goldenhar Syndrome, Hydrocephalus, Miller Syndrome, Mobius Syndrome, Nager Syndrome, Orbital Hypertelorism, Pfeiffer Syndrome, Roberts Syndrome, Stickler Syndrome, Velo-cardio-facial Syndrome, and Waarenburg Syndrome.
Details This fund will assist families who have children with facial deformities with certain medical expenses. This program will only cover expenses not covered by insurance and does not cover medical costs.
Eligibility Guidelines The family will need to provide financial documentation and live in Nassau County.
How To Apply Call the program to get more information and to apply
Area of Service New York

Program Name Shriners Hospitals for Children
Program Address PO Box 31356
Tampa, FL 33621
Phone Number 800-237-5055
Diseases Orthopedic Conditions, Burn Injuries, Spinal Cord Rehabilitation, Cleft Lip, Palate Repair.
Web Site No link available.
Details Shriners Hospitals for Children are located throughout the United States and the hopsitals provided free care to children whom have a reasonable possibility that the child's condition can be helped by the the hospital.
Eligibility Guidelines The child must be under the age of 18. There are not any income limits.
How To Apply Call the program or go to the website to get an application.
Area of Service National

Clotting Disorder

SpecialPatientsInNeed

Post Office Box 1566

Ormond Beach, Florida 32175-1566

Spin.meds@gmail.com

Toll Free: 1-866-572-7944

Facsimile: 1-229-873-9727

Special Patients In Need

(Medication Assistance Program)