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Application

Financial Assistance Guidelines

 

Purpose

The goal of this program is to financially assist patients and their families who reside in Interior Alaska, in dealing with financial challenges faced when undergoing cancer treatment. Assistance may include (but is not limited to) travel expenses to treatment locations, local transportation, housing/utilities, non-covered prescriptions, childcare, groceries, and gas. 

 

Application Process

A financial assistance application must be completed and submitted to IACA. Applications are available below. They can downloaded and submitted online; hand delivered with prior coordination; or submitted through your health care provider.

The application must clearly state the type and amount of financial assistance requested. The IACA will review each application and a decision will be made as soon as possible. If you have questions about submitting an application, please email us at info@interioralaskacancer.org.

 

Qualifications

To qualify, the applicant must submit a completed application and meet all the following criteria:

 

  1. The applicant must be a resident of Interior Alaska, as defined by the IACA Board of Directors, and must reside in Interior Alaska for greater than 6 months out of the year. (See Map and Description of the Interior on our Services Page)

  2. The applicant must not have the same or comparable financial assistance (or in-kind services) available to him/her though any other federal or state agency or any medical insurance, or other program.

  3. The applicant must secure a signed statement from their physician verifying they are currently being treated for cancer, and attach it to the application. For our purposes the IACA defines a physician as an MD or a DO licensed to practice medicine in the State of Alaska.

 

Payment

Successful applicants will not receive cash payments. Bills and other requests are paid directly to the vendor by the IACA.

 

Limitations

The IACA reserves the right to place limits on financial assistance so that others may fully benefit from the program.

To submit your Application - 

- Download application

- Fill in all fields

- Get Physician Verification Letter

- Email to info@interioralaskacancer.org attach Application & Verification

*if you are not able to submit, having trouble, or have questions - email us at info@interioralaskacancer.org

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