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Medicare dimista copay relief verification#

LLS offers patients, caregivers, pharmacies, and healthcare providers two easy ways to register/apply:

Medicare dimista copay relief verification#

In the event that you are unable to get your doctor to sign off on the Diagnosis Verification Form for your application, we will accept a portion of your electronic medical record (EMR) or other documentation that shows the diagnosis/ICD-10 code. *Healthcare Professionals (HCP) applying on behalf of a patient will be asked for their NPI and tax ID. This information will not be shared and is for verification purposes only. The name of treating physician and their phone/fax numbers.The name of your pharmacy and its phone/fax numbers.Insurance card, as well as Medicare/Medicaid.If the patient is a minor, you will need a guardian Social Security number as well.The patient's demographic information (including their Social Security number and date of birth) and their contact information.STEP 1: Gather the following information. If you prefer to apply on your own, please refer to the information below. You may call (877) 557-2672 to speak with an Intake Specialist who can walk you through the application process. Please visit our website in the future to become aware of new funding. 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. *Philadelphia Chromosome Negative Myeloproliferative Neoplasms only.Īs a non-profit organization, we rely on the generosity of our sponsors. Plasma cell leukemia or plasma cell myeloma.Juvenile myelomonocytic leukemia (JMML) (diagnosis formerly known as chronic myelomonocytic leukemia of infancy ).

Please refer to our booklet, Non-Hodgkin Lymphoma, for additional subtypes ( click here).

Post-transplant lymphoproliferative disorder or PTLD.

T-cell large granular lymphocytic leukemia (LGL).

We encourage you to continue to check our website for updates on available funding.įully subscribed and closed to enrollment Please note that hospitals who run a charity care program establish their own eligibility criteria.Ĭlick Here to learn more about Dollar For. They also help patients prepare and submit applications with the hope of reducing or eliminating medical bills. We know you are struggling, and we are working to secure funding to help more patients and while doing so we continue to support those enrolled in our co-pay program.Īs an additional resource to help patients with the high cost of cancer care, LLS has partnered with Dollar For, an organization that helps patients determine if they are eligible for charity care through their hospital. We hear you we know that lack of funding to cover your co-pays for medical expenses and/or insurance premiums adds to the stress and anxiety brought on by the financial burden of your diagnosis. We understand that the LLS Co-Pay Assistance Program helps to remove some of those barriers. LLS is committed to removing the barriers patients face in accessing care.

The Trish Greene Back to School Program.