Reimbursement Frequently Asked Questions

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To be eligible for reimbursements, you must be enrolled in a TAF financial assistance disease program. TAF does not issue reimbursements through our copay disease programs.

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You will receive reimbursements through a TAF-issued PNC Bank debit card that is funded pursuant to TAF’s policies and procedures. If you are the parent or legal guardian of a patient under the age of 18, the debit card may be issued in your name. 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.

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

Prescription medication copays (FDA-approved treatment for the disease named in the program)
Health insurance premiums
Therapy administration costs
Treatment-related travel costs
Disease management (such as prescribing-physician copayments)
Emergency services
Diagnostic and genetic testing
Durable medical equipment

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

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

Health insurance premiums: Master plan document, insurance plan detail, or employer benefit summary (to be submitted once a year), and proof of payment.
Prescription copayments: Pharmacy prescription receipt and proof of payment.
Medical incidentals: Explanation of benefits and proof of payment.
Travel: Proof of treatment and proof of payment.
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.

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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:

Health insurance benefit statement
Health insurance plan details
Summary of benefits
Insurance plan detail
Employer benefit summary
Master plan document

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.

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

Payment confirmation from your insurer
Bank statement
Pay stub from your employer
Front and back of a canceled premium payment check

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

Show the health insurance premium was paid
Include the primary beneficiary’s name
Include the name of family members, if any, on the insurance plan
Include the insurance company name or logo
Include the coverage period
Include the premium frequency and amount
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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.

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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.

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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.

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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.

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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.

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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:

Date of transaction
Business name and logo
Name of the medication
Total cost
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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.

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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:

Sample Mapquest image

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Most reimbursement requests are processed within six business days of TAF’s receipt of all necessary documentation. You will receive reimbursement through a TAF-issued PNC Bank debit card that is funded pursuant to TAF’s policies and procedures.

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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.

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

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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.

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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)

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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.

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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:

After-visit summary from doctor
Explanation of benefits (EOB) from your insurance company
A health insurance billing claim form (UB-04) provided by the site of care

Reimbursement Table