You can then begin entering your application information. Once you submit your portal registration, you'll receive an email (typically within five minutes) directing you to a website to create your password. Healthcare provider/Facility’s National Provider Identifier (NPI)*.To create a portal account you will need the following: If this is your first time visiting the LLS Financial Assistance Portal, you will need to register before you can start the online application. This information will not be shared and is for verification purposes only. Physician’s information (first and last name, and location).

Please note that these patients will be required to submit documentation to verify identity.

Patients who do not have a Social Security number or Alien ID number should call (877) 557-2672 to apply.If patient is a minor (under the age of 18), patient AND guardian’s Social Security Numbers and date of birth are required.The patient’s Social Security Number and date of birth.Please note that these patients will be required to submit documentation to verify identity.Ĭlick here to download the paper application. Patients who do not have a Social Security number or Alien ID number should call (877) 557-2672 to apply. Please note: There is a separate portal for the Co-Pay Assistance Program. Have NOT received a Patient Aid Program award in the past.Have a confirmed diagnosis of blood cancer, be in active treatment, scheduled to begin treatment or in follow up care.territories at the time of their application.

Program continuation is dependent on the availability of funds and the program could be modified or discontinued at any time if funding is limited or no longer available. There are no income criteria to qualify for this program patients can be insured or uninsured.Īs a non-profit organization, we rely on the generosity of our sponsors. Eligible patients will receive a one-time $100 stipend to help offset non-medical expenses like transportation, food, housing, utilities, etc. The LLS Patient Aid Program, in partnership with Subaru of America and its retailers, provides financial assistance to blood cancer patients. To access this page in Spanish, click here. We Want to Hear How This Program Has Helped You!.This page contains information about the following topics: The Trish Greene Back to School Program.

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