Grant-based Disease Programs
Grant-based limits allow TAF to help as many patients as possible access the treatment they need. TAF applies grant-based limits in a small number of disease programs where there is high variability in patient out-of-pocket costs.
TAF’s grant-based programs provide a fixed amount of financial assistance for copays, coinsurance, and deductibles for all FDA-approved treatment for the disease named in the program. The grant amount is determined by the disease program.
Enrolled patients may also receive assistance with health insurance premiums and incidental medical expenses (as outlined in the program coverage details). These expenses are not counted toward the grant amount and there is no cap on the amount of assistance a patient can receive for these eligible expenses in a calendar year.
To learn more about what out-of-pocket medical expenses are covered in a disease program, visit TAF’s Disease Program Hub.
If the value of the grant runs out and the disease program’s enrollment status is “open,” the grant will be automatically renewed. TAF will send the patient a new Member Card with a new group number, which must be provided to their healthcare provider.
If the status of the program is “waitlist,” patients may apply for, or be referred to, the disease program waitlist. Patients will not be automatically placed on the waitlist. To learn more about TAF’s waitlists, visit https://tafcares.org/patients/taf-disease-program-waitlists/.
No. TAF copay grant programs only assist with copays, coinsurance, and deductibles for FDA-approved treatment for the disease named in the disease program.
Yes. TAF financial assistance grant programs assist with copays, coinsurance, and deductibles and health insurance premiums and incidental medical expenses. Reimbursements for health insurance premiums and incidental medical expenses are not counted toward the grant amount. There is no cap on the amount of assistance a patient may receive in a calendar year for these eligible expenses.
No. Patients in a grant-based disease program do not need to apply for reenrollment. TAF will send two Member Cards to patients receiving a grant during this time: one for the current year and one for the upcoming year. Patients must give their healthcare provider the new Member Card in the new year.
The grant amount is determined by which disease program a patient is enrolled in. If a patient is conditionally approved or they enroll in the last quarter of the year, their grant amount may be adjusted.
Patients conditionally approved for a grant-based disease program are eligible for 30 days of assistance or up to the specified grant amount, whichever comes first. The grant amount for a conditionally approved patient is equivalent to one month of the total grant amount. Once a patient has completed the application and is fully approved, they are eligible for assistance for the calendar year in which they’re enrolled or up to the full grant amount, whichever comes first.
TAF conducts annual assessments to determine which disease programs offer grants and which offer unlimited copay assistance. The Program Terms and Conditions of a disease program will not change during the year a patient is enrolled. If the Program Terms and Conditions of a disease program are slated to change in the upcoming year, TAF will notify patients in advance.
Yes. TAF will notify patients once their copay grant amount has been used. Patients may continue to submit reimbursement requests for incidental medical expenses through the end of the calendar year.