Patient Aid Program Guidelines
Downloadable application form at bottom of page.
Please read these Guidelines before downloading the form.
General Overview
the Bone Marrow & Cancer Foundation’s Patient Aid Program provides one-time grants to lessen the burden of transplant-related expenses. Each patient is eligible for a maximum of $1,000 in financial assistance. Currently, the average grant is between $300 and $500.
The patient must be affiliated with a certified transplant center and must be on track to have a bone marrow, stem cell, or cord blood transplant or still be receiving post-transplant care.
Please write legibly when completing the application. Please keep a copy for your own records.
The social worker or nurse completing the application should mail the original to the Bone Marrow & Cancer Foundation for evaluation. Faxed or emailed forms will not be accepted.
Completing the Application
A physician at the transplant center must verify the patient’s diagnosis and treatment and sign the indicated section of the application.
The remainder of the application should be completed primarily by a social worker or nurse coordinator at the transplant center who will be or has been following the patient through the transplant process.
Social Worker/Nurse Coordinator
In order to understand the nature of the patient’s need and properly evaluate the application, please be as specific as possible when completing the application and consider all members of the household when completing the financial information.
The names of any other organizations which have provided financial or in-kind assistance to date, as well as any dollar amount received or pending, must be disclosed.
In the employment section, “Expected End Date” refers to when the individual will be required to leave his/her job due to the transplant procedure or caregiver responsibilities, and the previous employment information is only requested if the individual is not currently employed. The Social Summary should describe additional factors beyond the financial information that should be considered during the evaluation process (ex. length of time unemployed, health concerns of another family member, other significant expenses, etc.). The Service Request should explain the assistance requested, with specified amounts for each if possible (ex. $150 for gas, $325 for insurance premium, etc.) If necessary, feel free to attach an additional page for this information. It is not necessary to submit receipts or financial records.
Once the application has been submitted, all communication should be between the social worker or nurse and the Bone Marrow & Cancer Foundation. Be certain that the contact information is correct and legible. Inability to contact the social worker or nurse may result in the evaluation being delayed or the application being declined.
Type of Assistance
Patient aid funding may be requested to cover costs associated with:
- donor search
- compatibility testing
- donor harvesting
- medical treatment
- health insurance premiums and co-pays
- medication and medical supplies
- home and day care
- transportation
- accommodations
- psychosocial supplies
- sperm banking
- cord blood banking
- legal fees
- living and housing expenses (ex. rent, utilities, groceries, etc.)
- caregiver expenses related to transplant
For questions about other expenses, contact the Bone Marrow & Cancer Foundation.
Evaluation and Decisions
All sections of the application must be completed before it will be considered for evaluation. Incomplete applications will be returned to the social worker or nurse.
Once the application has been submitted, all communication should be between the social worker or nurse and the Bone Marrow & Cancer Foundation.
Processing time for Patient Aid requests is approximately 8-10 weeks. All requests are acknowledged, at the time of receipt, to the social worker or nurse indicated on the form. Another letter/e-mail will be sent once a decision has been reached.
As a specific amount of funding is available annually for the Patient Aid Program, patients demonstrating the most financial need are given priority. If approved, Patient Aid will be given only in the form of a check from the Bone Marrow & Cancer Foundation made payable to the individual or entity listed as such on the application.
Patients whose initial request is declined may reapply if there is a change in their socioeconomic or medical status. Patients reapplying must complete a new application.
Multiple requests for a patient who has already received financial assistance will not be accepted.
the Bone Marrow & Cancer Foundation reserves the right to deviate from these Guidelines on a case-by-case basis when special circumstances arise.
Download Patient Aid Program Application