Financial assistance programs can help with medical bills

Even though Stephanie Marshall worked in the healthcare industry for decades, it wasn’t until she took a position with The Assistance Fund (TAF) that she learned about nonprofits that provide financial aid to patients who can’t afford to pay their medical bills. Now that Marshall is director of patient advocacy for TAF, one of those nonprofits, she is an expert in collaborating with patient advocacy organizations to raise awareness of charitable patient assistance.

“I had never heard of this whole world of charitable patient assistance,” said Marshall. “So, now, when I go to a conference and explain what we do, people are like, really? It’s like the best-kept secret, but it shouldn’t be a secret.”

Charitable patient assistance programs operate as independent nonprofit organizations that help patients manage costs associated with chronic, rare, or life-threatening diseases. In addition to financial assistance, the programs may provide recommendations for other patient support organizations and offer patient advocacy and education.

Not many people know about patient financial assistance, according to poll findings recently released by the Patient Access Network (PAN) Foundation. The poll found that only 24% of patients with chronic conditions were familiar with financial assistance programs. The poll also revealed that 37% of those with chronic health issues needed financial support, but of those, only 41% ended up receiving it.

“That really made us think, ‘Wow, we have a lot of opportunity to grow awareness,’” said PAN Foundation President and CEO Kevin Hagan, in a media release video. “More importantly, we know internally from working with our patients that 90% of patients who receive financial assistance from PAN report that it has a positive impact on their health outcomes, their overall quality of life, and their outlook on life.”

The Immune Deficiency Foundation (IDF) features TAF, the PAN Foundation, and other charitable organizations as resources that support patients and caregivers. The support offered by the organizations ranges from financial help with prescription costs to travel for specialty care to analyses of specific insurance plans. IDF also provides a list of manufacturer co-pay assistance programs and organizations focused on specific types of primary immunodeficiencies (PI).

Each patient assistance organization is unique in its programs and services, eligibility criteria, and policies. It’s important to research the organizations before applying for assistance.

TAF, for example, provides financial assistance to people with high out-of-pocket medical expenses such as prescription and clinician co-payments and other treatment-related costs, including monthly health insurance premiums, travel costs related to treatment, laboratory tests, and genetic testing. Patients receive funding through reimbursement of expenses.

“We cover those costs that the patient pays out of pocket, and costs shifted to the patient by the insurer. We help make up that difference, particularly since many of the treatments and related costs are quite high today,” said Marshall.

TAF assists with funding for roughly 100 conditions, including chronic granulomatous disease (CGD), hereditary angioedema (HAE), and PI in general. Those interested may apply for assistance with more than one condition if they have comorbidities.

To be eligible for funding through TAF, applicants must have health insurance coverage that is either public, such as Medicare, Medicaid, and Tricare, or private. The cap on income for an applicant is based on the annual income amount and household size.

“The assistance is there to help people who have really serious life-changing and sometimes life-threatening conditions. When I meet people at conferences and have that face-to-face conversation, they’ll say, ‘Well, there may be other people who need it more than I do,’ and I always say, ‘If you are eligible, the financial assistance is here for you and we are here to support you and your family,” said Marshall.

“The way I talk about this—and I think this applies to the foundation—is that we’re all pieces of a quilt, and the patient, because of our healthcare system, has to often put those pieces together. We at TAF are a piece of the quilt that supports patients.”

At TAF, disease programs are listed as open, waitlisted, or closed. Open programs are currently accepting new applications. Waitlisted programs are temporarily unavailable to new applications because funding has been fully allocated, and TAF is working to secure additional donations.

When a program is marked as closed, TAF is processing waitlist applications and extending enrollment invitations to applicants at the top of the waitlist. During this time, no new waitlist applications are accepted. Programs marked as closed typically begin accepting new waitlist applications within a few days.

“I tell people not to be discouraged by the waitlist, but to go ahead and apply. Healthcare is costly, and these costs can be a burden, so they should never feel they can't access financial assistance,” said Marshall.

In contrast to TAF, the PAN Foundation has disease funds for roughly 80 conditions, and while it doesn’t assist with PI specifically, it does have programs for PI comorbidities, such as autoimmune conditions and cancers.

Through the PAN Foundation, patients may apply for grants to assist with co-pays, health insurance premiums, and transportation. These grants can vary in size based on income caps as well as the specific disease program.

Like Marshall, Hagan encourages patients who are diagnosed and being treated for a condition to apply for funding, even if there is a waiting list.

“We really believe that no one should have to choose between their healthcare and their financial well-being,” said Hagan.