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Financial Assistance for women's healthcare

2005 Insurance Coverage
2006 Insurance Coverage

62 days after being laid off

 

CDP: Detection Programs: Every Woman Counts
1-800-511-2300. This program from the California Department of Health Services offers free breast and cervical cancer screening exams and necessary diagnostic procedures to women who qualify by age and income. California residents may enroll in the program through numerous clinics and some doctor's offices statewide. Information about the program and referral to local health care providers may be obtained by calling the 800 number listed above. Assistance is available in six languages – English, Spanish, Mandarin, Cantonese, Korean and Vietnamese.

Women who live in one of 10 Northern California counties (Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Napa, Plumas, Shasta, Siskiyou, Sonoma, Tehama and Trinity) may also call the Northern California Breast and Cervical Cancer Partnership for assistance at 1-800-682-2282. Partnership staff provide helpful, client focused assistance with aspects of breast and cervical cancer screening, diagnosis and treatment.



To qualify for Cancer Detection Programs: Every Woman Counts, women must be:

  • A California resident

40 years or older (for breast services) or 25 years or older (for cervical services)

  • Un-insured or under-insured, e.g., someone with limited insurance coverage or "Emergency Only Medi-Cal"
  • At or below the federal income guidelines. These guidelines are updated each year. The following are effective April 1, 2005

2006 HHS Poverty Guidelines

Persons in
Family or Household

48 Contiguous
States and D.C.

Alaska

Hawaii

1

$ 9,800

$12,250

$11,270

2

13,200

16,500

15,180

3

16,600

20,750

19,090

4

20,000

25,000

23,000

5

23,400

29,250

26,910

6

26,800

33,500

30,820

7

30,200

37,750

34,730

8

33,600

42,000

38,640

For each additional
person, add

 3,400

 4,250

 3,910


CCAN: The Breast and Cervical Cancer Coordination and Navigation Program
Call 1-888-921-7465. This program provides no cost statewide support to individuals symptomatic or diagnosed with breast or cervical cancer. Citizenship does not matter. CCAN can offer financial assistance and/or utilize extensive referral networks to help patients with the resources needed to maintain or regain wellness. CCAN helps with the following services: transportation to treatment, domestic help, wigs and hats, bras and prostheses, lymphedema garments, emotional support and educational materials. The toll-free help line is answered by bilingual (English/Spanish speaking) staff who can provide translation assistance in many other languages. After conducting a needs assessment, CCAN assists patients through their cancer experience, working to meet critical unmet needs. To qualify for CCAN, individuals must be:

  • A California resident
  • Diagnosed or symptomatic for breast or cervical cancer
  • Uninsured or underinsured
  • At or below the same income guidelines listed above

Financial assistance for breast and cervical cancer treatment

California Department of Health Services, Breast and Cervical Cancer Treatment Program (BCCTP)
The federal Breast and Cervical Cancer Treatment Act was signed into law in 2000 as a result of grass-roots efforts among cancer survivors and their families. California's BCCTP is funded by state and federal matching funds to pay for treatment of breast or cervical cancer for women or men with breast cancer who qualify by income. The program is available in sixteen northern California counties ( Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Napa, Plumas, Shasta, Siskiyou, Sonoma, Tehama and Trinity). You may get more information by calling the Northern California Breast-Cervical Cancer Partnership at 1-800-682-2282. You can enroll in BCCTP through the same providers who administer the Cancer Detection Programs: Every Woman Counts program and Family Pact Program (FPACT). This program offers Medi-Cal coverage during cancer treatment for those eligible.

Applicants who do not meet federal requirements may still qualify for State-only BCCTP. Eligible applicants will receive Medi-Cal coverage limited to cancer treatment for 18 months for breast cancer and 24 months for cervical cancer. This would include males regardless of age, individuals with out-of-pocket health insurance costs over $750 annually, and men or women with "qualified alien" immigration status. Call 1-800-824-0088 for clarification.

Financial assistance - additional resources

American Cancer Society
1-800-227-2345
24 hours, seven days a week - cancer information, support and community resources.
www.cancer.org
This respected organization offers a range of information, resources and publications. Local units provide practical and emotional services for cancer patients, including transportation to and from medical appointments, support services, and wigs and head coverings for women in treatment. Staff can accept calls in Spanish and distribute most publications in Spanish.

California Major Risk Medical Insurance Program (MRMIP)
1-800-289-6574
ww.mrmib.ca.gov
This program provides health insurance for qualifying Californians who are unable to obtain coverage on the open market. The program is funded by $40 million from the state's tobacco tax fund. Services are delivered through contracts with health insurance providers. Qualifying Californians share the cost of their coverage by paying premiums, and then the program supplements those premiums to cover the cost of care. Insurance agents make no profit on this policy.

Costs related to clinical trials
National Cancer Institute
www.cancer.gov/clinicaltrials/learning/laws-about-clinical-trial-costs.
Some states require health plans to cover patient care costs in clinical trials. For more information, see the National Cancer Institute's information at the web site address listed above.

Department of Social Service
This agency of your local county sometimes has emergency funds for rent, food, utilities, prescription drugs and medical expenses for those who are not eligible for other programs. Transportation services may be offered or mileage reimbursed. Funds are often limited. Information can be obtained by contacting your state or local Department of Social Services. Check your local telephone directory for their phone number.

Fundraising
Some patients find that friends, family and community members are willing to contribute financially if they are aware of a difficult situation. Contact your local library for information about how to organize fundraising efforts.

Health insurance and disability benefits
www.cancer.ucsf.edu/crc/
There is an extensive written article on insurance and public benefits by Danial Fortuno and Keren Stronach, MPH. It is available through the Cancer Resource Center at the Comprehensive Cancer Center of the University of California at San Francisco (UCSF). Call the Cancer Resource Center at 415-885-3693.

Medi-Cal
This county-administered federal program may pro-vide medical coverage for people with low income, those with no/or limited medical insurance, and people with disabilities. Personal property, excluding house and car, cannot exceed a limited value, which was $2,000 for one person in December 2004. You must apply in your county of residence. Eligibility and benefits may be somewhat different in each California county.You can check income limits for medi-cal eligibility. If you do not qualify for Medi-Cal, you may still qualify for a related program in your county that requires you to pay a monthly "share of costs." Your doctor's office or hospital can give you the best local telephone number to call. You can also call 916-445-4171 and listen carefully to the phone options.

Unfortunately, many people with Medi-Cal experience delays because the pre-authorization process moves slowly.

Medi-Cal/HIPP (Medi-Cal/Health Insurance Premium Payment)
A state program that may pay for private health insurance premiums to enable an individual to receive continuous coverage instead of relying solely on Medi-Cal. Call 1-866-298-8443 for information on application procedures.

Medicare
Call 1-800-633-4227. www.medicare.gov
Medicare is a federally-funded health insurance program that covers most Americans over age 65 and some people with disabilities. It provides for basic health coverage although not for all medical expenses. Co-payments and deductibles may be required. Basic benefits are determined by Congress and are the same across the country. Private supplemental insurance "Medigap" policies increase the range of coverage. Contact Medicare for information on eligibility, explanations of coverage and related publications. Some publications are available in Spanish and Spanish-speaking staff is available.

NeedyMeds
www.needymeds.com
Provides information about patient assistance programs funded by pharmaceutical companies with programs to assist people who cannot afford to buy the drugs they need. Your doctor's office can supply you with direct lines to the Patient Assistance Programs of certain companies (see below).

Patient Assistance Program
1-866-512-3861
email: pap@patientadvocate.org
A subsidiary of the Patient Advocate Foundation (see entry under "Insurance Advocacy") providing financial assistance to patients who meet certain qualifications. May help pay for prescriptions and/or treatments. Helps patients who have insurance including Medicare and Medi-Cal. This assistance lets patients who have chronic, life threatening and/or debilitating illnesses afford the out-of-pocket costs that their insurance companies require. Telephone counselors screen for eligibility. Once eligibility has been deter-mined, a comprehensive application is processed. Patients are assigned their own call counselor who will be available to answer questions. Once the individual is approved for the program and depending on the level of need, payments may be made to the doctor, to the pharmacy or to the patient directly.

Programs of assistance at hospitals
Some hospitals have programs through which uninsured and low-income patients may qualify for assistance with their hospital expenses. Ask to speak with a hospital financial counselor or social worker about application procedures.

Social Security Administration
1-800-772-1213
www.ssa.gov/notices/supplemental-security-income/
Takes applications for Medicare, Social Security Insurance (SSI) and Social Security Disability Insurance (SSDI). Apply with Social Security if your doctor feels that your disability will last one year or more. Applications can take three to four months for processing.

United Way
www.unitedway.org
This national organization's information service can refer you to an agency that may provide financial help for rent, food and other basic necessities. To find the United Way serving your community, visit their web site (listed above) or check the white pages of your local telephone book.

Veteran's Administration
1-877-222-8387
www1.va.gov.health/
Eligible veterans and their families may receive cancer treatment at a Veteran's Administration Medical Center. Some publications are available in Spanish, and Spanish-speaking staff is available in some offices.

Insurance advocacy

California Consumer Health Care Council
415-666-0757
Advocates with insurance companies and health providers on behalf of patients.

California Department of Insurance
Consumer Hotline 1-800-927-4357
www.insurance.ca.gov/0100-consumers/
This web site offers instructions and a form to request mediation of an insurance claim or coverage problem. Staff will review your complaint if you believe you have received improper denial or underpayment of a claim, delay in settlement of a claim, alleged illegal cancellation, or termination of an insurance policy.

California Department of Managed Care HMO Help Center
1-888-HMO-2219
www.hmohelp.ca.gov
Can help you resolve problems with your health plan, including issues about medical care, prescriptions, preventive testing and mental health services.

A Consumer Guide to Handling Disputes with your Employer or Private Health Plan
1-800-656-4533
www.kff.org/consumerguide/7350.cfm
This booklet offers guidance for denied claims and is provided by the Consumers Union and the Kaiser Family Foundation. It discusses "internal reviews" for handling complaints and appeals inside a health plan and "independent reviews" to provide an unbiased way to resolve disputes between patients and their health plans.

Health Insurance Information
www.healthinsuranceinfo.net/
This project of the Georgetown University Health Policy Institute offers on-line and printable versions of A Consumer's Guide to Getting and Keeping Health Insurance for each state. These consumer guides are updated periodically to reflect changes in federal and state policy.

Patient Advocate Foundation
Call 1-800-532-5274.
www.patientadvocate.org/help.php
Provides education, legal counseling, and referrals for cancer patients and survivors concerning managed care, insurance, financial issues, job discrimination and debt crisis matters. Professional case managers and attorneys specialized in mediation, negotiation and education will advocate on behalf of patients.

Legal assistance

California Women's LawCenter, Breast Cancer Legal Clinic
1-888-774-5200
Provides information and support to women regarding legal issues and cancer.

Cancer Legal Resource Center
213-736-1455
www.lls.edu/academics/candp/clrc.html
This is a community-based joint program of the Western Law Center for Disability Rights and Loyola Law School. The CLRC provides information and educational outreach on cancer-related legal issues to people with cancer, their families, friends, employers and those who provide services to them. The program provides prompt and confidential information in English and Spanish on legal aspects of health insurance, State Disability Insurance, Medicare, Medi-Cal, financial management, the Family & Medical Leave Act, COBRA, managed care and other issues.

Legal Services of Northern California
1-800-222-1753.
Legal hot line for seniors. Free phone consultation.

Patient Advocate Foundation
Call 1-800-532-5274.
www.patientadvocate.org/help.php
Provides education, legal counseling, and referrals for cancer patients and survivors concerning managed care, insurance, financial issues, job discrimination and debt crisis matters. Professional case managers and attorneys specialized in mediation, negotiation and education will advocate on behalf of patients.
Public Interest Clearinghouse
1-425-834-0100
www.pic.org
Works with over 100 nonprofit civil and legal aid programs in California, including law schools and students, law firm practitioners, the State Bar, the courts and others in the community. Provides legal services to low-income people in the areas of family law and eviction defense. Offers information seminars, self-help clinics and referral to volunteer attorneys.


Utility bills

Pacific Gas and Electric Smarter Energy Line
1-800-933-9555
www.pge.com/res/financial_assistance/
Offers utility discounts based on medical needs. Also, CARE at 1-800-743-5000. Monthly discounts for income-eligible customers.

REACH (Relief for Energy Assistance through Community Help)
1-800-933-9677
A one-time energy-assistance program sponsored by Pacific Gas and Electric Company and administered through the Salvation Army. REACH helps low-income customers who experience unplanned hardships and are unable to pay for their energy needs. Generally, recipients can receive REACH assistance only once within a 12-month period.

Telephone Assistance Programs
Most telephone phone companies have reduced rates based on low income or medical necessity. Call your phone company for details.

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