Effective Monday, October 3, 2016, the Co-Pay Assistance Program will utilize a third party income verification system, making it easier for patients to apply for assistance. This enhancement will eliminate the requirement to submit income documents. In the rare instance that the system is unable to verify a patient’s income, LLS will contact the patient to request income documents.
This page contains information about the following topics:
- Available Funding
- Eligibility Requirements
- How to Apply
- Claims Information
- Frequently Asked Questions
- Contact Information
- Covered Expenses
- Co-Pay Resource Guide
The Leukemia & Lymphoma Society (LLS) Co-Pay Assistance Program helps you pay your insurance premiums and meet co-pay obligations. We'll also help you find additional sources of financial aid. The Co-Pay Assistance Program offers financial help toward:
- Blood cancer treatment-related co-payments
- Private health insurance premiums
- Medicare Part B, Medicare Plan D, Medicare Supplementary Health Insurance, Medicare Advantage premium, Medicaid Spend-down or co-pay obligations
You have complete freedom to choose doctors, providers, suppliers, insurance companies and treatment-related medications. You can make changes to these at any time without affecting your continued eligibility.
Support for this program is based on the availability of funds by disease diagnosis. LLS Co-Pay Assistance funds are available for the following diagnoses:
- Acute lymphoblastic leukemia - fully subscribed and currently not accepting new applications
- Chronic lymphocytic leukemia - assistance is available up to $5,000 (for applicants approved on or after 7/5/16)
- Chronic myeloid leukemia - fully subscribed and currently not accepting new applications
- Lymphoma (Hodgkin and non-Hodgkin) - assistance is available up to $2,500 (for applicants approved on or after 1/1/14)
- Mantle cell lymphoma - assistance is available up to $5,000 (for applicants approved on or after 12/13/13)
- Myelodysplastic syndromes - assistance is available up to $5,000
- Myeloma - assistance is available up to $10,000
- Waldenström macroglobulinemia - assistance is available up to $5,000 (for applicants approved on or after 5/11/15)
**As a non-profit organization, we rely on the generosity of our sponsors. Program continuation is dependent on the availability of funds and the program could be modified or discontinued at any time if funding is limited or no longer available. Please visit our website in the future to become aware of new funding.**
To be eligible for Co-Pay Assistance, you must
- Have a household income that is at or below 500 percent of the U.S. federal poverty guidelines as adjusted by the Cost of Living Index (COLI).
- Be a United States citizen or permanent resident of the U.S. or Puerto Rico and be medically and financially qualified
- Have medical insurance and/or prescription insurance
- Have an LLS Co-Pay Assistance Program-covered blood cancer diagnosis confirmed by a doctor (see covered diagnoses listed above)
Online: Patients, caregivers, pharmacies and healthcare providers can easily submit online Co-Pay applications with a quick registration process, day or night. Your doctor, treatment provider or pharmacy can also apply for the program on your behalf.
- Patients and Caregivers: Submit an application now
- Pharmacies and Healthcare Providers: Submit a patient application now
Patients and providers may apply for assistance and check the status of submitted applications and claims 24 hours a day via the online portal.
By Phone: You may apply or get more information about the Co-Pay Assistance Program by calling (877) 557-2672 to speak with a Co-Pay Specialist who will provide personalized service throughout your application process.
For patients with approved applications who need assistance completing the Co-Pay Claim Form, please refer to the Claim Form Information Guide. The Co-Pay Claim Form is not available on the website for downloading. Please contact the Co-Pay Assistance Program at (877) 557-2672 to request a form.
In most cases, the payment will be sent directly to your pharmaceutical supplier, hospital, doctor and less commonly, directly to the patient. Claim requests for less than $20 will not be processed.
Click here for a list of covered and non-covered expenses.
Click here to access a list of frequently asked questions about the Co-Pay Assistance Program.
The Leukemia & Lymphoma Society
Co-Pay Assistance Program
P.O. Box 12268
Newport News, VA 23612
Toll Free Phone: (877) 557-2672
Fax: (877)-COPAY-FAX or (877) 267-2932
Access the Co-Pay Resource Guide for information regarding Pharmaceutical Patient Assistance Programs.