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Patient Financial Assistance Program

Our goal is to equitably administer financial assistance to help your patients overcome barriers before and after transplant.

Who is eligible for patient financial assistance?

Patients are eligible for financial assistance from NMDPSM if they are actively being treated for their disease at the time of the application, have a household income less than 350% of the Federal Poverty Level, and meet any of the following criteria:

  • Pre- transplant
    Patient has a formal search through the NMDP RegistrySM with intention to move forward with an allogeneic hematopoietic cell transplant (HCT) facilitated by the NMDP (related or unrelated).
  • Post-Transplant
    Patient had an NMDP-facilitated transplant within three years of application submission date (related or unrelated). OR Patient had an NMDP-facilitated transplant (related or unrelated), is at least 90 days post-transplant and is actively being treated for chronic graft-versus-host disease (GVHD).
  • Clinical Trials
    Patient is enrolled or in the process of enrolling in a clinical trial to treat a blood cancer, blood disorder or HCT complication and needs assistance covering travel expenses.
  • Search assistance fund
    Patient has insufficient or no insurance for search and procurement activities facilitated by NMDP and needs assistance covering these expenses.

Please contact us if a letter confirming pre-approval is needed to move forward with donor testing.

What can patient financial assistance cover?

Our funding helps patients with costs before and after transplant, which may include:

  • Unexpected financial burdens (unemployment, extended hospital stay expenses, car troubles, etc.)
  • Out-of-pocket costs related to medical care (copays for medication, clinic visits and dental work)
  • Non-medical out-of-pocket costs for patients and caregivers (temporary housing, food, gas, etc.)
  • Medical costs associated with chronic GVHD management
  • Travel costs related to clinical trials
  • Costs related to fertility preservation for patients with sickle cell disease
  • Inadequate health insurance coverage for search and procurement activities facilitated by the NMDP
  • An emergency or crisis event that is impacting access to transplant or directly affecting post-transplant care (see Crisis Grant details below)

The grants were a gift from heaven. When you’re sick and can’t work for a year or more, you don’t know what you’re going to do…the grants made such a big difference in our lives!

–Bruce, transplant recipient

How do I apply for patient financial assistance?

Applications must be submitted by a health care professional through our secure online application. The data in this application is for internal use only and will never be shared. We determine patient eligibility within five business days and award an amount using a sliding scale. If approved, patients will receive funds in the form of the payment method selected in the application.

Availability of patient financial assistance depends on funding and is not guaranteed, regardless of eligibility.

Use the Pre-transplant, post-transplant, and clinical trial travel grants worksheet to help you prepare the information needed for the online application.

Have an exception for High-Resolution Typing Assistance? Download the High-Resolution Typing Assistance form and return the completed form to your case manager.

What specialized grants are available for patients?

High-Resolution Typing Assistance

When a patient cannot access timely HLA typing for themselves or family members, our High-Resolution Typing Assistance can help. We complete HLA typing via buccal swabs on your behalf and provide the typing results to your center free of charge. Use our free High-Resolution Typing Assistance when:

  • Your patient does not have insurance
  • Insurance authorization is delayed
  • Your patient’s insurance does not cover high-resolution HLA typing for the patient and/or a family member
  • You need HLA typing for more than one family member and it is not covered by insurance

To request High-Resolution Typing Assistance for a patient or their related donors, download the request form and return it to your case manager.

Search Assistance Funding

When patients have insurance barriers preventing them from moving forward with transplant, NMDP provides a Search Assistance Fund (SAF) grant payable to the transplant center for the patient. This fund assists patients by covering up to $20,000 of NMDP search and procurement fees billed to the patient by the transplant center that insurance doesn’t cover.

Note: SAF is not available when patients are not responsible for payment of denied claims or limitations due to payer/provider contractual agreements.

Please contact us if a letter confirming pre-approval is needed to move forward with donor testing.

Qualifying to SAF

To qualify for SAF reimbursement all the following must be true:

  • Patient has limited or no coverage for search and procurement and will be billed for these fees OR patient is uninsured
  • For uninsured patients, must have attestation by health care team for how the remainder of transplant costs will be paid for
  • Activities for reimbursement were facilitated by NMDP
  • Related transplants must be facilitated by NMDP Related Donor Services
  • Invoice(s) submitted with reimbursement request are no more than 12 months old

You must submit appropriate documentation with your request. If we do not receive the proper documentation, your request will be denied. Appropriate documentation includes:

  • Explanation of payment the payer provided to your center outlining patient responsibility. We cannot accept the patient’s account summary from the facility.
  • Patients’ insurance policy documentation outlining coverage. For CMS, please submit the related coverage document.
  • NMDP related invoices

Examples of eligible scenarios for reimbursement

Eligible for SAF

  • Prior authorizations have been denied after being appealed*
  • Patient has no insurance
  • Patient responsibility for NMDP fees owed to facility

Not eligible for SAF

  • Charges patients cannot be billed for as stated by the payer or contractual agreement. Including cases where patient has met their deductible and out-of-pocket maximum for their plan year.
  • Claim denials due to lack of prior authorization
  • Services performed outside NMDP, with exception of up to $790 for CT done at an outside lab
  • Payments to Medicare when patient died prior to transplant**

Crisis Grant

The Crisis Grant, founded by Ira & Diana Riklis, can provide up to $10,000 for patients experiencing a crisis directly impacting their access to transplant.

To be eligible, all the following requirements must be met:

  • Patient must have had or is scheduled to have NMDP facilitated transplant
  • Patient or family has an emergency or crisis event prohibiting patient from receiving required treatment and/or impact the patient’s health
  • Pre-transplant: Must have a donor/cord ready for workup
  • Post-transplant: Must actively be receiving care
  • Patient must reside in the United States
  • Patient's household income does not exceed 350% of the federal poverty line
  • Income does not exceed monthly costs, including costs needed for the crisis

If your patient meets the Crisis Grant eligibility requirements, please email our Patient Financial Assistance team to request the application. Please request a new application for each patient. Crisis Grant applications must be submitted by a transplant center staff member.

Sickle Cell Disease Fertility Preservation Grant

The Sickle Cell Disease Fertility Preservation Grant can give a limited number of qualified patients up to $10,000 towards preserving fertility prior to transplant. This grant can cover expenses including, but not limited to, oocyte retrieval/embryo culture/cryopreservation, semen analysis/ freezing, storage fees and medications.

To be eligible for the Sickle Cell Disease Fertility Preservation Grant, all the following must be true:

  • Patient has a diagnosis of sickle cell anemia
  • Transplant team has identified donor or cord blood for collection
  • Patient’s household monthly net income is within 350% of the Federal Poverty Level
  • Patient had a fertility clinic consultation and estimate of costs

If your patient meets the Fertility Preservation Grant eligibility requirements, please email our Patient Financial Assistance team to request the application. Applications must be submitted by a member of the patient’s care team.

Other Resources

Our patient navigators can help patients and caregivers get answers to financial and insurance questions, cope with uncertainty and connect with others who understand the transplant process. Email the Patient Navigator team or call them at 1 (888) 999-6743

Financial Resources for Patients

Browse our Materials Catalog for free financial resources for your patients.

It’s hard for many patients to keep paying their mortgage, utilities or credit card debts when there are so many new bills to pay after transplant. If it’s hard for your patients to keep up with all their bills, suggest they call their creditors, explain their situation and ask about getting lower, more manageable monthly payments. Many will understand and work with a patient.

If your patients need help talking to creditors about lowering their payments, suggest they call a nonprofit consumer credit counseling service. These organizations can help patients set a budget and they can also work with creditors to come up with a payment plan. Call 1 (800) 388-2227 or visit the National Foundation for Credit Counseling.

Questions?

Email our Patient Financial Assistance team or call them at 1 (763) 406-8114

 

*Requests submitted for pending PA’s will be denied
** Reference the alloHSTC Cost-Based Reimbursement Webinar