Reimbursement Frequently Asked Questions

As of September 23, 2024, TAF provides reimbursements through direct electronic payment. To see what expenses are covered in your program, visit enroll.tafcares.org or call (855) 845-3663 to speak with a Patient Advocate. Reimbursement requests can be submitted by electronic document upload, fax, or mail; however, the most efficient way to submit documentation is in TAF’s Patient Portal.

Expenses eligible for reimbursement vary by disease program but may include:

To check what reimbursement expenses are included in your disease program, visit https://enroll.tafcares.org/ and select your disease program.

Eligible expenses must be supported by acceptable documentation. Proper documentation is dependent on the reimbursement item. See below for acceptable documentation:

Please allow up to six business days for review of your reimbursement documentation. If your reimbursement request is incomplete, you will receive a letter informing you of what additional documentation is required to validate the expense. You will also receive an action item in the Patient Portal. If you do not submit the requested documentation within 30 days of the date of the letter, TAF will cancel the reimbursement request.

Some TAF disease programs provide reimbursement for health insurance premiums. Each year, patients must submit a document that clearly summarizes the key features of their health insurance plan with their initial reimbursement request. There are many different names for this document depending on the health insurance company. Some examples are:

If you change health insurance plans during the year, you must submit to TAF a new master plan/summary of benefits and coverage document to continue receiving health insurance premium reimbursements.

To be reimbursed each month for health insurance premiums, TAF requires one of the following forms of documentation:

Each time the premium is paid, your supporting documentation must:

Yes. If you’re on Medicare, you may submit your Social Security benefits statement as your summary of benefits. To be reimbursed each month, TAF still requires proof of payment each time the premium is paid. If you are covered under a family member’s plan, the summary of benefits and coverage must include your name on the insurance plan.

In some financial assistance programs, TAF provides reimbursement for copays, coinsurance, and deductibles for approved tests, exams, and appointments related to the FDA-approved treatment for the disease named in the program. Documentation must include the date of service, copay amount, and name of the specialist. Visit your disease program page at https://enroll.tafcares.org/ to see which reimbursement expenses are included in the program.

In some financial assistance programs, TAF provides reimbursement for medical transport services, emergency medical services, and emergency department visits (up to $200 per claim). Visit your disease program page at https://enroll.tafcares.org/ to see which reimbursement expenses are included in the program.

In some financial assistance programs, TAF provides reimbursement for specific durable medical equipment. To find out what equipment is eligible, call the phone number listed on your disease program’s webpage on the TAF website.

In some financial assistance programs, TAF provides reimbursement for approved specialists. To find out whether specialists are included in your disease program, call (855) 845-3663.

TAF requires proof of payment and proof of treatment for all reimbursement claims. Proof of payment can be a paid billing invoice, a receipt, or a bank statement that includes a logo. All proof-of-payment documents must include:

TAF requires two documents for all reimbursement claims: proof of treatment and proof of payment. Proof of treatment can be an explanation of benefits (EOB) from your insurer, a health insurance billing claim form (UB-04), or a billing invoice from your site of care.

TAF requires two documents for all reimbursement claims: proof of treatment and proof of payment. For treatment-related travel expenses like mileage, hotel lodging, or meals, please submit an explanation of benefits (EOB) from your insurer, a health insurance billing claim form (UB-04), a billing invoice from your site of care, or an after-visit summary from the specialist.

Mileage: You may submit screenshots of “MapQuest” or other navigation applications showing departure and arrival locations

Sample MapQuest image:

Most reimbursement requests are processed within six business days of TAF’s receipt of all necessary documentation. As of September 23, 2024, TAF provides reimbursements through direct electronic payment.

You may submit all eligible expenses from the current calendar year dating back to Jan. 1 or the date the disease program opened. Eligible expenses for the previous benefit year are cut off on March 31.

Due to the high volume of claims we receive during this time period, your reimbursement may be delayed.

No. The quickest way to receive your reimbursement requests is by submitting them right away through TAF’s Patient Portal.
You may also submit your reimbursement requests by electronic document upload, mail, or fax at (833) 789-1228.

The Assistance Fund will only reimburse the portion of the monthly health insurance premium for the person actively enrolled in a TAF disease program. (e.g., a person in a family of five would receive one-fifth of the health insurance premium)

If your reimbursement request is missing any necessary documentation, TAF will send you a letter detailing what additional documentation is required. If you do not submit the requested documentation along with the Incomplete Claim Verification Letter within 30 days of the date of the letter, TAF will cancel your reimbursement request. If you have questions about what your reimbursement request is missing, call (855) 845-3663, Monday through Friday from 8 a.m. – 7 p.m. ET.

Patients in some TAF disease programs are eligible for treatment-related travel reimbursements. TAF only provides travel allowance to sites of care for therapy administration and visits to specialists approved for the disease program. All reimbursement requests must be related to office visits or FDA-approved treatment for the disease named in your disease program. The transaction date must match the date when the treatment was received. Please refer to the table below for travel reimbursement allowance amounts.
Acceptable document examples for proof of treatment include, but are not limited to:

Yes. Beginning on September 23, 2024, PNC Bank will send a check for your next TAF reimbursement to the address we have on file. To get immediate electronic reimbursements, call us at (855) 845-3663 to update your contact preferences to text or email. When your next reimbursement is approved, you will receive a notification from PNC Bank with a link to select your new payment method.

Yes. TAF is implementing reimbursement enhancements effective September 23, 2024. When your next TAF reimbursement is approved, PNC Bank will send you a notification. You will have the option to select direct deposit, direct debit card transfer, or online payment for that reimbursement. You will also have the option to select your default payment method for all future reimbursements. If you do not select a default payment method, you will need to select your payment method each time you receive a new TAF reimbursement.

The easiest way to monitor the status of your reimbursement requests is through TAF’s Patient Portal. If your reimbursement request was approved, and you have not received your reimbursement through your preferred payment method, please call us at (855) 845-3663.

As of Monday, September 23, 2024, TAF began providing reimbursements by direct electronic payment for patients enrolled in TAF disease programs who have a TAF-issued PNC Bank debit card. This new process reduces the time it takes to receive your reimbursements. To learn more, visit tafcares.org/pnc-bank.

Your PNC Bank debit card will be deactivated on January 5, 2025. Any remaining funds on the PNC Bank card as of January 5, 2025, will be sent to you by check.