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    Guidelines

    The CACC provides assistance to cancer patients that reside in Champaign County.

    No services will be provided by the CACC unless a signed and approved application (Pages 1 and 2) for services has been filed with the CACC.

    The maximum monthly ($500.00) financial assistance is for any or all services per approved patient.

    Patients may use the pharmacy of their choice. The patient is responsible to ensure that the pharmacy has the correct billing information and that the CACC has approved financial support for their prescription.

    The CACC will provide financial assistance only to medical providers (facilities) and pharmacies for cancer-related expenses. No direct reimbursement will be made to individual patients without the consent and approval of the CACC Board of Directors.

    The CACC will not be responsible for financial assistance towards the patient's bill except as provided under the section titles Oncologist/Treatment Facility - Financial Assistance.

    The CACC will continue to financial assistance (up to the monthly maximum) for 60 days after the patient's death. Bills, invoices and financial requests received after this will not be assisted by the CACC. 

    The CACC reserves the right to modify monthly financial assistance schedules based on current demand and financial position of the Association.

    Fuel/Travel Assistance - Treatments

    ​The CACC will assist in the purchase of fuel for the transportation of patients receiving CANCER RELATED (CR) treatments at a physician's office, cancer center or hospital. Patients will be provided a fuel car to use when purchasing gasoline for trips to/from treatments. The patient is required to provide CACC with a doctor's order (sent from the doctor’s office/treatment center) that outlines the type of treatment (chemo, radiation,…), number of treatments being prescribed, the dates of those treatments, and the location of them. The patient is also required to provide confirmation (from the doctor’s office/treatment center) that the prescribed treatments were used. This report shall include dates of treatments/visits, and must be signed by the doctor or a representative of the office/treatment center.
     
    $10.00 per day/treatment to Springfield, Urbana, Bellefontaine, Upper Valley Medical Center, Troy, London, Marysville.
     
    $15.00 per day/treatment to Columbus or Dayton.
     
    A maximum of $15.00 per day may be charged (i.e., you may not charge $10.00 for a trip to Springfield and then charge$15.00 for a trip to Dayton or Columbus on the same day). Patients will have the option of using the card at the daily rate or of filling up at the time of purchase. However, additional fuel cards will not be issued until more treatments are prescribed. Failure to file the doctor's orders (notify your social worker to submit any changes or new treatment plans) and failure of the patient to submit the confirmation form  (patient receipt of fuel card(s)) may result in loss of fuel expense financial assistance.

    Oncologist/ Treatment Facility - Financial Assitance

    ​The CACC will financially assist patients with bills for CANCER RELATED (CR) treatments received at the doctor's office, cancer center or hospital. This does not include routine office calls (follow-ups or checkups) to the doctor's office, cancer center or hospital. Financial assistance will be provided after all other patient coverage (insurance, Medicare, etc.)  has been exhausted. Patients must submit an itemized statement from the provider, showing the dates of service, cancer related charges, the balance due after payments received from insurance, Medicare, other entitlements are credited, and the department/address to where financial assistance may be applied. Actual bills must be received by the patient and forwarded (scanned and emailed or copies mailed) to Patient Services Director of the CACC. The CACC will not accept MY CHART or similar financial disclosure applications. Actual bills (copies thereof) must be submitted and financial aid will be sent to the patient’s provider. 
     
    Financial assistance will be provided in the order that the bills are received by the Patient Services Director.

    Prescription Assistance

    ​Cancer-related (CR) prescription assistance will be provided after all other patient coverage (insurance, Medicare, etc.) has been exhausted, up to the $500.00 maximum monthly benefit.
     
    LOCAL PHARMACIES and PRESCRIPTIONS
    The patient must notify their local pharmacy of their application to the CACC for assistance and notify the CACC that the patient has CR prescriptions being filled at said pharmacy. The CACC must acknowledge the prescription and approve it before financial assistance is accepted. Financial assistance will be provided to the pharmacy after all other patient coverage (insurance, Medicare, etc.) has been exhausted. The invoice needs to include the patients name, medication, dispense date, quantity provided and payment address.

    ​THROUGH THE MAIL PRESCRIPTIONS
     
    Prescriptions through the mail may be approved by the CACC. The CACC must acknowledge the prescription and approve it before financial assistance is applied. The patient shall be responsible to have the prescribing oncologist/physician or related social worker notify the CACC of the request for financial assistance towards cancer related prescriptions. Financial assistance will be provided after all other patient coverage (insurance, Medicare, etc.) has been exhausted. Bills for mail prescriptions must be sent to the CACC and include the prescriber’s name, medication, dispense date, quantity provided and the department/address to where financial assistance may be applied.
     
    The CACC will assist with CR prescribed miscellaneous personal incidentals not covered for CR HOSPICE patients.  The total of all expenses cannot exceed the maximum benefit. Chemotherapy and radiation treatments will be covered as prescriptions and will follow the above guidelines

    Wigs/ Prosthetics Assistance

    ​The CACC will assist with the purchase of necessary CR prostheses at the following rates:
    Wigs/toupees - $125.00. Once every two years.
    Bras/forms - $200.00 with a limit of 2 per year.

    Contact Info
    Please read carefully:

    I find the above information to be correct and understand that any payment by the CACC on my behalf will be made only on amounts due after insurance and other benefits available to me have been credited. 

    No CACC financial assistance will be paid directly to me.

    I give permission for the oncologist, primary care physician, treatment center, or pharmacy to share my relevant information with the CACC in order that I may receive assistance from the CACC. I understand that the CACC will not release any information about me to the public without my permission.
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