Eligibility requirements for TotalAssist funds

Eligibility requirements across the TotalAssist funds typically share a common set of criteria, but some funds vary. Find your fund and check its specific eligibility requirements.

Typical eligibility requirements

• Have a qualifying diagnosis of a condition covered within our TotalAssist program, verified by the patient’s medical care team
• Have a household income of 500% or less than the Federal Poverty Level (FPL) guidelines, adjusted by the Cost-of-Living Index (COLI) for where the patient lives. 
• Have active insurance coverage that includes coverage for pharmaceutical products 
• Be a legal resident of and receive treatment in the U.S. or a U.S. territory 

Funds may vary

By type of insurance coverage required

• Government-insured health coverage (Medicare, Medicaid, or TRICARE)
• Any health insurance coverage
• No coverage required. This applies only to our transportation fund.

By household income requirement

• Household income of 300% or less than the Federal Poverty Level (only our obesity fund)
• Household income of 500% or less than the Federal Poverty Level (all other funds)

By the approved medications requirement

• Some funds do not have an associated approved medications list (for example: cancer genetic and genomic testing)
• TotalAssist funds allow for flexible coverage of out-of-pocket healthcare expenses, including but not limited to medication copays. If the patient’s prescribed medication is not covered by their insurance or is not in the approved list, their awarded grant can be used for other covered expenses.

Health Equity Funds

In addition to other requirements stated by the fund, to be eligible for a TotalAssist Health Equity Fund, the patient must live in an eligible zip code. Learn how we determine health equity eligibility.

Related: Diagnosis verification, Income verification

Pages: Find your fund, Federal Poverty Level guidelines, Terms and conditions