Financial Relief
Funds, not to exceed $500, will be provided for covered home expenses or out-of-pocket costs for medical supplies including (Durable medical equipment, incontinence supplies, and enteral feeding supplies/formula)
Home Expenses
- For primary residence where the applicant resides
- The billing due date must be greater than 21 days from your completed application date (your application is not complete until all required documentation has been submitted)
- The billing statement must be in the parent or legal guardian’s name. If you are the applicant must be in your name
- Only one (1) bill will be paid per application, not to exceed $500
- Covered home expenses:
- Mortgage/Rent
- Utility (water, gas, electric)
- Cable
- Internet
- Home Phone
- Cell Phone (for the applicant only)
Durable Medical Equipment (DME)
- Payment, not to exceed $500, for items that are not affordable by the applicant and are not covered by insurance
- Covered Durable Medical Equipment includes:
- Prescribed DME equipment
- Incontinence Supplies
- Enteral Feeding Supplies including Formula
Travel Assistance
- Upcoming appointment must be 4 weeks or greater from your completed application date (your application is not complete until all required documentation has been submitted)
- Must provide upcoming appointment information: from your patient portal or on doctors letterhead
- Must include patient name, date of appointment, the name of clinic/office, and the address.
- Must send back doctors note in order to apply again for this program