This page contains information about the following topics :

• Available Funding
• Program Eligibility Criteria
• How to Apply
• Claims Information
• We Want to Hear How This Program Has Helped You!
• Frequently Asked Questions
• Contact Information 
• Covered Expenses and Drugs
• Other Helpful Resources

The Co-Pay Assistance Program offers financial help toward:

• Blood cancer treatment-related co-payments
• Private health insurance premiums
• Medicare Part B, Medicare Plan D, Medicare Supplementary Health Insurance, Medicare Advantage premium, Medicaid Spend-down or co-pay obligations

You have complete freedom to choose doctors, providers, suppliers, insurance companies and treatment-related medications. You can make changes to these at any time without affecting your continued eligibility.

 

Available Funding

Support for this program is based on the availability of funds by disease diagnosis. Funds are available for the following:

**As a non-profit organization, we rely on the generosity of our sponsors. 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. Please visit our website in the future to become aware of new funding.**

 

Program Eligibility Criteria

To be eligible for Co-Pay Assistance, you must

• Be a United States citizen or permanent resident of the U.S. or U.S. territory.
• Have a household income that is at or below 500 percent of the U.S. federal poverty guidelines as adjusted by the Cost of Living Index (COLI). You will be asked for your zip code to determine your COLI.
• Have medical insurance and/or prescription insurance 
• Have a blood cancer diagnosis confirmed by a doctor
  • Patient must be in active treatment, scheduled to begin treatment, or is being monitored by their doctor.
    
     

How to Apply

STEP 1: Gather the following information

• The patient's demographic information (including their Social Security number and date of birth) and their contact information.
  • If the patient is a minor, you will need a guardian Social Security number as well.
• The name of your diagnosis.
• Household financial income.
• Insurance card, as well as Medicare/Medicaid.
• The name of your pharmacy and its phone/fax numbers.
• The name of treating physician and their phone/fax numbers.

This information will not be shared and is for verification purposes only.

*Healthcare Professionals (HCP) applying on behalf of a patient will be asked for their NPI or tax ID.

STEP 2: Contact the Program

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

• By Phone: (877) 557-2672
  Monday to Friday, 8:30 a.m. to 5:00 p.m.
• Online: Online portal 
  24/7, Available in English only

STEP 3: Apply

If this is your first time visiting the LLS Financial Assistance Portal, or applying, you will need to register before you can start the application.

• Begin registration form, either online or by phone.
• Submit registration form.
• Receive confirmation email (typically within 5 minutes of submitting) that provides a link for you to create a password.
• Create password
• Log on to the LLS Financial Assistance Portal using newly created password.
• Begin application process. All required fields must be filled.
• Upon completing your application, submit for approval.

If you are returning to the LLS Financial Assistance Portal, please log in, select Co-Pay Assistance Program, and fill out required fields.

Awards are based on a first-come, first-served basis, for as long as funding is available. Submitting the application doesn't guarantee acceptance in the program. Your application will be reviewed, and you will be notified of your status.

For portal technical support, please call us at (877) 557-2672 or e-mail financialassistance@lls.org

Online Portal Tutorials (available in English only):

LLS has created multiple, on-demand tutorials that walk viewers through various portal functions, acquainting them with the location of important icons and features. Below is a link to each tutorial:

Claims Information

Please contact the Co-Pay Assistance Program at (877) 557-2672 for instructions on how to submit a claim.  

Click here for a list of covered and non-covered expenses.

Click here for a quick reference list of covered drug categories.

We Want to Hear How This Program Has Helped You!

We would love to hear how the financial assistance provided by LLS has helped you. Patient stories help us illustrate the impact and importance of this program in the lives of blood cancer patients.

Submit a Story 

To submit a story by mail, please send to:

The Leukemia & Lymphoma Society
Patient Financial Assistance Programs
3 International Drive, Suite 200, Rye Brook, NY 10573

Thank you for sharing!

Frequently Asked Questions

Click here for FAQs.

 

Contact Information

The Leukemia & Lymphoma Society
Co-Pay Assistance Program 
P.O. Box 12268
Newport News, VA 23612

Email: FinancialAssistance@LLS.org
Toll Free Phone: (877) 557-2672
Fax: (877) 267-2932

Office of Inspector General (OIG) Advisory Opinion

• OIG Advisory Opinion No. 06-13 dated 9.18.06
• OIG Advisory Opinion No. 06-13 dated 6.21.13
• OIG Advisory Opinion No. 06-13 dated 5.21.14 

Other Helpful Resources

• Other Financial Assistance
• Assistance with Prescription Drug Costs for Insured Patients 
• Assistance with Prescription Drug Costs for Uninsured Patients
• Health Insurance - US
• Access the Co-Pay Resource Guide for information regarding Pharmaceutical Patient Assistance Programs.
• Access this page in Spanish