Our patient aid application is currently open.
The third quarter applications will run until Friday, March 12, at 5:00 p.m.
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You will receive an email confirmation of your application once you apply.
If you have not heard from Leukemia Texas eight weeks after a deadline, you may reach out to Leukemia Texas to check on the status of your application.
PATIENT AID PROGRAM
The Leukemia Texas Patient Aid program awards assistance up to $1,000 per year to help patients with expenses associated with their leukemia treatment not covered by insurance or other third party providers. Applications to the program are accepted on a quarterly basis, at the end of March, June, September, and December, and grants are awarded at the end of each application cycle. Applicants that receive Patient Aid assistance must wait every other year before applying again.
READ CAREFULLY BEFORE APPLYING.
Leukemia Texas is an independent nonprofit corporation dedicated to fighting the life-threatening blood cancer of leukemia through the funding of leukemia research and patient aid in Texas. Through its Patient Aid program, Leukemia Texas provides financial assistance to leukemia patients needing help with their necessary treatment expenses. This program currently serves hundreds of children and adults each year.
Funds raised to support the Patient Aid Program statewide, come from Leukemia Texas Signature Fundraising Events and restricted awards from generous donors and partners. Leukemia Texas prioritizes applicants based on the criteria (regionally and demographically) to meet donor guidelines.
Applications MUST be completed entirely. All questions and sections, except photograph consent and questions about race/ethnicity, are required and must be answered to be considered for assistance. Missing information will result in a denial.
Applications MUST be submitted electronically online. Electronic methods only include submitting through the secure online platform. Applications are no longer accepted through the mail, email, or fax, and will not be considered.
Duplicate applications or multiple applications. If an applicant submits more than one application in a quarter, the most recent application will be considered, and the previous application will be discarded. Applications will be considered and reviewed based on when they are received through the Online Portal on the Leukemia Texas website.
Diagnosis and ICD10 Codes. Leukemia Texas only supports patients diagnosed within three (3) years with leukemia. This can include Acute and Chronic leukemias, and associated subtypes. Type of leukemia must be indicated on application under “Diagnosis”(do not simply write ‘leukemia’ in the diagnosis.) The ICD10 code must match the diagnosis or the request will result in a denial. At this time, Leukemia Texas does not support other blood cancers or similar diseases (ex. MDS, Multiple Myeloma, Aplastic Anemia, Lymphoma, etc.).
Patient Updates. Leukemia Texas sends out status notifications to patients within 6-8 weeks of the quarterly deadline date, not the date the application was submitted. Notifications are mailed out through US Postal Service. Status updates are not given over the phone or through email. Calls or emails about status updates may not be returned. Leukemia Texas will also send out a status update to the social worker/care provider listed on the application after all notification letters have been mailed.
Application Deadlines. Each application has the most current quarter deadline. Previous versions or old applications will not be considered.
Patients must be alive at the time that the aid is issued. Financial assistance related to postmortem expenses or expenditures incurred after death will not be considered.
Diagnosis Date. Applicants must have been diagnosed or relapsed within the last three (3) years.
Reapplication. Applicants that receive Patient Aid assistance must wait every other year before applying again. The window is based on when aid is received, not when the application is submitted. Applicants reapplying within a 24-month period will be denied.
Funding Disbursement and Utilization. Checks are valid for 120 days from the date on the check. Checks will not be reissued after the 120-day period and will be voided, regardless of approval status. Checks can only be issued to the patient listed on the application or legal guardian in cases where the patient is a minor. Checks cannot be reissued to family members, friends, or caretakers and will not be reissued after death.
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- Patient must have an active leukemia diagnosis, and currently undergoing treatment, within 3 years of diagnosis, for leukemia with a licensed physician/provider.
- Patient must be a legal citizen or legal resident of the United States of America.
- Patient must be a legal resident of, and currently live in, the state of Texas.
- Patient cannot have received Leukemia Texas Patient Aid Assistance within the last 24 months.
Eligibility does not guarantee approval.
Care Team/Health Care Provider Verification.
Patient’s treatment and diagnoses must be validated by two persons providing care or assistance to the patient through their current physician’s office or hospital. Care team members MUST include Name, Title, Valid Phone Number and Email. Contact information CANNOT be the same as the Social Workers. Patients will be denied if all information is not provided.
Accepted Providers (need two):
- Physician (MD or DO)
- Physician Assistant
- Nurse Practitioner
- Social Worker
- Financial Advisor
- Practice Manager
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If patient meets the eligibility criteria outlined above, they may apply for patient aid.
- Application must be filled out online at leukemiatexas.org.
- Once received, application will be held until processing, which occurs within six (6) to eight (8) weeks after the deadline.
- Once all applications are processed, patients will be notified of the status of their application in writing via US Postal Service.
- Online applications will be verified with the care team through correspondence from the Program Manager.
- If you have not heard from Leukemia Texas eight weeks after deadline, you may reach out to Leukemia Texas to check on the status of your application.
- Leukemia Texas relies on the accuracy of the information provided on each If you have a change of address after you submit your application, please reach out to Leukemia Texas to provide us with the current information.
- Leukemia Texas reserves the right to request additional documentation to validate application information.
- Leukemia Texas reserves the right to request a new annual application for all enrollees to ensure system accuracy and applicant eligibility, as we update our application each quarter.
- If you have any questions, please feel free to contact the Leukemia Texas Program Manager at (214) 265-7393 or [email protected]
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Priorities of Leukemia Texas when approving Patient Aid:
(Priorities are not a determination of approval or denial, but a tool for our committee to evaluate our applicants based on our mission and patient needs)
• Leukemia Texas was founded to assist patients across Texas, specifically with a leukemia diagnosis of any type. Due to the wide scope of the population that is affected by leukemia, we as an organization, do our best to serve those in greatest need, while understanding that all leukemia patients are in need.
• Leukemia Texas requests that all applicants provide as much information as possible on their application to give our Program Committee the best idea of how their leukemia diagnosis has affected them financially.
- In the narrative, please provide a description of the current financial state the patient is in due to the diagnosis:
- Provide information about what financial strains are put on the patient due to the current treatment plan they are or will be going through.
- Provide information on any other obstacles that are now adding to the financial strain due to the leukemia diagnosis.
- One-sentence statements or phrases will not be considered (ex. “Severe financial hardship”, “financial assistance needed”, “Need for meds and transportation”)
• Leukemia Texas and the Program Committee will look at all information provided in the patient’s application to determine their priority.
- Leukemia Texas Priority for Patients:
- Priority will be given to those patients that have expressed a financial need based on the treatment they will undergo requiring 100+ total inpatient or outpatient days for treatment
- Priority will also be given to those that may require travel of longer distances to receive their therapy, incurring higher expenses due to the length of travel, cost of parking or even multiple overnight stays during treatment
- Priority will be given to those patients in a situation of little or no insurance.
- This priority is not stating that simply because one has insurance they will not receive priority over someone Insurance can be present, but still have very costly attributes, i.e. high deductibles and prescription copays. Through a proper description of their financial situation in the narrative of the application, patients are able to best present their needs, even while having insurance.
- We also recognize that certain treatments are not covered by insurance, e. experimental medications, clinical trials, etc.
• Patients that are US citizens or legal US residents, residents of Texas and currently undergoing treatment for any form of leukemia are still able to apply but realize that we look at each application carefully to consider who will receive funding.