Patient Frequently Asked Questions
General Program Information
We assist with the out-of-pocket treatment costs for nearly 100 diseases. Visit https://enroll.tafcares.org/ to see the full list of TAF’s disease programs.
To be eligible for a TAF disease program, you must:
› Be a U.S. resident with health insurance (government-sponsored or private)
› Meet income requirements
› Be diagnosed with a disease for which we have a disease program
› Have a prescription for an FDA-approved treatment for the disease named in the program and it must be covered by health insurance
You may receive assistance simultaneously through multiple copay and financial assistance disease programs if you meet each program’s eligibility criteria and funding is available.
When a provider/pharmacist refers you to The Assistance Fund for copay assistance, expect the following:
1) We will review the referral information against the disease program’s eligibility criteria.
2) If the referral meets the disease program’s eligibility requirements, you will be conditionally approved, allowing your pharmacy to dispense your prescribed medication for 30 days.
3) We will mail to you a welcome letter with an enrollment application the following business day. You must complete and return the application by the conditional approval expiration date stated in the letter.
4) To continue to receive assistance beyond the 30-day conditional approval period, you must submit a completed application, including your signature and agreement to the disease program terms and conditions, within the conditional period.
5) If we receive your completed application by the required date and you receive full active approval, you will receive assistance through the end of the calendar year (unless otherwise specified).
When a provider/pharmacist refers you to The Assistance Fund for financial assistance, expect the following:
1) We will review the referral information against the disease program’s eligibility criteria.
2) If the referral information meets the disease program’s eligibility requirements and funding is available, we will mail to you a welcome letter with an enrollment application.
3) If we receive your completed application and proof of health insurance coverage, you are approved for participation in the program for the calendar year (unless otherwise specified). As part of your participation in the program, you must provide insurance plan details to receive health insurance reimbursements.
If you are approved for participation in a disease program, you will receive assistance on a calendar-year basis (unless otherwise specified). Thereafter, you must reapply for assistance each calendar year. Reenrollment occurs during the fourth quarter of each calendar year, and you will be notified when the reenrollment period opens. For more information on TAF reenrollment, visit our Reenrollment FAQs page.
Assistance in any year is always subject to the availability of funds and there is no guarantee such funds will be available.
Conditional approval gives you 30 days of immediate assistance for open disease programs accepting new applications where funding is available. To receive assistance beyond those 30 days, you must submit to TAF a completed application, including your signature and agreement to the program terms and conditions. If you apply online, sign electronically, agree to the program terms and conditions, and meet all criteria, you will be approved for the full calendar year (unless otherwise specified).
When applying for TAF assistance, you must provide and verify your demographic, insurance, and financial information. If additional documentation is required, we will let you know.
No. You should never pay a fee to apply for enrollment in an independent charitable patient assistance organization. For more information on independent charitable patient assistance organizations, visit our Patient Resources Hub or call one of our Patient Advocates at (855) 845-3663.
The quickest way to submit documentation is through TAF’s Patient Portal. In the Portal, you can submit reimbursement requests and check the status of the requests. You may also submit reimbursement documentation by electronic document upload, fax, or mail.
If your insurance changes, you only need to inform TAF if your new insurance plan does not cover a portion of your FDA-approved treatment. If your new insurance plan does not cover a portion of your FDA-approved treatment, you will no longer be able to receive TAF assistance.
TAF sends a quarterly patient newsletter to all patients enrolled in a TAF disease program. The quickest way to update your contact information and ensure you receive all TAF communications is to log in to your Patient Portal account and confirm your phone number and email address. You can also update your contact information by calling us at (855) 845-3663.
No. While we are deeply grateful for every donation, applications are processed on a first-come, first-served basis.
Paying for Your Treatment
Our disease programs cover all FDA-approved treatment for the disease named in each program. We are unable to provide assistance for off-label use of medication.
Our financial assistance can be used with any pharmacy that:
1) is in your primary insurance’s network;
2) is able to dispense your medication; and
3) accepts our payment methods of electronic claims submission or manual paper claim submission.
To find out which pharmacies you can use, contact your doctor or health insurance provider. You will need to provide your TAF Member Card, which has all the information required for the pharmacy to process a claim, to your pharmacy.
Our financial assistance can be used with any site of care that:
1) is in your primary insurance’s network;
2) is able to provide your infusion treatment; and
3) accepts our payment methods of electronic claims submission or manual paper claim submission.
To find out which sites of care you can use, contact your doctor or health insurance company. You will need to show your provider your TAF Member Card, which has all the information required for your provider to process a claim.
Waitlist
When funding is available for a disease program, TAF will send you an invitation through your preferred communication method (voice call, text, or email) based on your position on the waitlist. When you receive the invitation, you must accept the invitation within 48 hours, or your invitation will expire. If you chose to receive a voice call, you will be able to accept your invitation by responding to the appropriate prompt. If you chose to receive a text or email, you will receive a link that will take you to the Waitlist Hub, where you can accept your invitation. Once you accept the invitation, you will be enrolled in the selected program.
You must accept the invitation within 48 hours or your invitation to enroll in a TAF disease program will expire. If you receive a voice call, you will be able to accept your invitation by responding to an automated prompt. If you receive a text or email, you will receive a link that will take you to the Waitlist Hub, where you can accept your invitation. Once you accept the invitation, you will be enrolled in the selected disease program.
If you need to update your waitlist application, please contact a TAF Patient Advocate at (855) 845-3663.
To check the status of your waitlist application, visit TAF’s Waitlist Hub. TAF’s Waitlist Hub provides real-time information on your waitlist status. Enter your last name, date of birth, and waitlist personal identification number (PIN) you received when you applied for the waitlist.
Your waitlist personal identification number (PIN) was displayed on the screen when you applied for the disease program waitlist. If you selected email or text as your preferred method of communication, your PIN was included in your waitlist enrollment confirmation. If you do not have access to your PIN, please contact a TAF Patient Advocate at (855) 845-3663.
You can remove yourself from a disease program waitlist by visiting TAF’s Waitlist Hub. Enter your last name, date of birth, and the waitlist personal identification number (PIN) you received when you applied for the waitlist. When your waitlist record is displayed, click “DECLINE.”
TAF will contact you when action is required. Otherwise, you can check your waitlist status online on TAF’s Waitlist Hub. To use the Waitlist Hub, enter your last name, date of birth, and waitlist personal identification number (PIN) you received when you applied for the waitlist.
A phone number is required to join a disease program waitlist. You then must select a method of communication (voice call, text, or email) when completing your waitlist application. TAF will use your preferred method of communication to contact you about required actions or changes to your waitlist status. It is critical that you provide accurate contact information, or you may not receive these communications.
If you join a waitlist, are invited to enroll, and accept enrollment in a TAF disease program, your coverage start date will be retroactive to the start of that calendar year. (If the disease program launched that year, the start date will be the disease program’s launch date.) You can submit covered expenses for reimbursement dating back to your coverage start date. Your provider may also submit outstanding claims dating back to your coverage start date.
If you are receiving assistance from another organization, you must decline your position on the waitlist on TAF’s Waitlist Hub. Enter your last name, date of birth, and the waitlist personal identification number (PIN) you received when you applied for the waitlist. When your waitlist record is displayed, click “DECLINE.” If you do not have access to your PIN, please contact a TAF Patient Advocate at (855) 845-3663.
No; each waitlist application is time- and date-stamped, and enrollment invitations are sent on a first-come, first-served basis when funding becomes available.
No. Once you receive and accept an enrollment invitation, you are eligible for financial assistance if you continue to meet the disease program’s eligibility criteria.
No; disease program waitlists expire at the end of each calendar year.
TAF’s waitlists are administered on a calendar-year basis, consistent with our disease programs’ calendar-year coverage periods. Patients who are on a disease program waitlist at the end of one calendar year must re-apply to join it at the beginning of the next calendar year.
No; Only patients who are active in a disease program are eligible for reenrollment. Patients on disease program waitlists will not receive an invitation to apply for reenrollment.
No. Patients must apply themselves to join a disease program waitlist in the new year if they are still seeking financial assistance.
Yes. If you select phone or text as your preferred method of communication, you will receive waitlist updates from this phone number.
Yes. When a new patient enrolls in a TAF disease program, they will receive a welcome call or text from a TAF Patient Advocate from this phone number.
Grant-based Programs
TAF applies grant-based limits to prescription drug copayments in a small number of its disease programs where there is high variability in patient out-of-pocket costs. Grant-based limits allow TAF to help as many patients as possible access the treatment they need.
TAF’s grant-based programs provide copay, coinsurance, and deductible assistance to you for the calendar year or up to the specified grant amount, whichever comes first. The grant amount is determined by the disease program in which you are enrolled. The grant may be used for copays, coinsurance, and deductibles for all FDA-approved treatment for the disease named in the disease program.
Enrolled patients may also receive assistance with other eligible out-of-pocket costs, such as health insurance premiums and incidental medical expenses (as outlined in the program coverage details), which are not counted toward the specified grant amount. There is no cap on the amount of assistance you receive in a calendar year for these eligible expenses.
To learn more about which out-of-pocket medical expenses are covered in your disease program, visit enroll.tafcares.org and select your disease program.
If the value of your grant runs out and the status of the disease program for which you are enrolled is “open,” your grant will be automatically renewed and you will receive another grant. If the status of the program is “waitlist,” you may apply for the disease program waitlist. To secure a place on the waitlist, you must complete an enrollment application and meet program qualifications. When funding is available, TAF will send you an invitation using your selected method of communication.
No. TAF copay grant programs only provide assistance for copays, coinsurance, and deductibles for FDA-approved treatment for the disease named in the disease program.
In addition to copay, coinsurance, and deductible assistance on FDA-approved treatment for the disease named in the disease program, TAF financial assistance grant programs provide assistance for other eligible out-of-pocket costs, such as health insurance premiums and incidental medical expenses. Reimbursements for health insurance premiums and incidental medical expenses are not counted toward the specified grant amount. There is no cap on the amount of assistance you receive in a calendar year for these eligible expenses.
No; If you’re in a TAF grant-based disease program, you will not participate in TAF reenrollment.
Yes. When you have exhausted your grant amount and your enrollment is automatically renewed, TAF will send you a new Member Card with a new group number. You must give your provider your new Member Card.
No. If you receive a grant in the last quarter of the year, you will receive two Member Cards: one for the current year and an additional one for the upcoming year. You must give your provider your new Member Card.
Your grant amount is determined by which disease program you are enrolled in. If you are conditionally approved or you enroll in the last quarter of the year, your grant amount may be adjusted.
Patients who are 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 you have completed your application and are fully approved, you are eligible for assistance for the calendar year in which you’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 your disease program will not change during the year you are enrolled. If the Program Terms and Conditions of your disease program are slated to change in the upcoming year, TAF will notify you in advance.
If you are in a grant-based disease program and TAF notifies you that your copay grant has been used, you may continue to submit reimbursement requests for incidental medical expenses through the end of the calendar year.