Co-Payment Assistance Fund
Head and Neck Cancer
Helping people with cancer access the prescribed treatments they need.
Program Status:
Closed
Eligibility Criteria
Diagnosis:
• Head and neck cancer ICD-10 code is C76. View list of ICD-10 codes »
• Primary cancer diagnosis must be the same as the fund and verified by the prescribing physician. Download Physician Verification Form »
Insurance:
• Patient must have health care insurance (any type)
Income:
• Income level must be at or below 500% of the Federal Poverty Level (FPL)
Citizenship:
• Must have a valid Social Security number to apply for assistance and receive treatment in the United States
Treatments Covered:
• Patient must be in active treatment or have a treatment plan in place prior to applying for assistance. Read more in our FAQs »
CCAF will consider retroactive reimbursement for first time applicants actively receiving a covered treatment. Our retroactive assistance will only consider dates of service within 60 days prior to the date we approve the application. Conditional approvals are not eligible for retroactive coverage.
Additional Services
CancerCare offers support services for people with head and neck cancer including counseling, support groups, financial assistance, workshops and publications.
Co-Payment Assistance Organizations
These organizations may be able to provide assistance. Please check their websites for up-to-date assistance information.