If your medication is not listed as approved

If your medication or product is not listed in your fund’s approved medications list, there are two considerations.

1. You can apply for the grant, but use grant funding for other eligible expenses
2. You can submit an inquiry about your medication to TotalAssist

Using grant funding for other eligible expenses

If you are awarded a TotalAssist grant, you must use the grant funding for eligible expenses. This includes the list of approved medications (or treatments) as mentioned in your disease fund. If you attempt to use your grant funding for a medication that is not listed as approved, the claim will be denied—often at point-of-sale at the pharmacy.

You can use your TotalAssist grant for eligible healthcare costs, including:

• Medication copays, coinsurance, and deductibles
• Health insurance premiums
• Office visit charges the day of treatment
• Administration charges related to treatment

Submit a request to add a medication to a fund’s approved list

The TotalAssist program provides financial assistance for treatments that are FDA-approved, listed in official compendia, and published in evidence-based guidelines related to the patient’s approved disease fund. Medications that do not meet these criteria will not be added to the approved medication list. The program does not cover supportive medications for most funds.

Please understand that Patient Advocate Foundation follows a rigorous research and review protocol for approving medications and treatments. As such, we cannot guarantee that your request will be granted, or that we will respond right away.

If you would like to request that we consider a medication be added to a fund’s approved list:

1. Download the request for medication form
2. Complete and sign the form
3. Fax to 757-952-3643

Other resources for patients beyond TotalAssist

Patient Advocate Foundation knows that patients may need support, information, and resources beyond TotalAssist. This can include services like case management, help with living expenses, and much more. Search our National Financial Resources Directory, find community specific resources, and explore our patient education library.

• Eligibility requirements
• Covered expenses