Susan Lang Pre CAR T-cell Therapy Travel Assistance Program

Susan Lang Pre CAR T-cell Therapy Travel Assistance Program is sponsored by Blood Cancer United. This program provides financial assistance to blood cancer patients undergoing evaluation for CAR T-cell therapy, either as standard treatment or a clinical trial.

## Susan Lang Pre-Car T-Cell Therapy Travel Assistance Program ### at Leukemia & Lymphoma Society - Greater Los Angeles Transportation, Transportation Expense Assistance Has eligibility requirements: **General Program Requirements:** * Have a blood cancer diagnosis confirmed by a doctor * Be in the process of being evaluated for CAR T-cell therapy, as either standard treatment or a clinical trial **Income Requirements:** Have a household income that is at or below 500 percent of the U.S. federal poverty guidelines as adjusted by the Cost of Living Index (COLI).

You will be asked for your zip code to determine your COLI. **Citizenship/Immigration Status Requirements:** Be a United States citizen or permanent resident of the U.S. or U.S. territories. The Leukemia & Lymphoma Society's (LLS) Susan Lang Pre CAR T-cell Therapy Travel Assistance program is available to blood cancer patients with significant financial need.

The fund provides financial assistance to patients diagnosed with a blood cancer who are being evaluated to receive CAR T-cell therapy as either standard treatment or a clinical trial.

Those who qualify will receive $2,500 to cover the cost of treatment-related travel and lodging expenses for the patient and caregiver including: * Car maintenance, repairs, and parts **Updates due to COVID-19:** For new applicants, in the event that you are unable to get your doctor to sign off on the Diagnosis Verification Form ​​​​​​for your application, they will accept a portion of your electronic medical record (EMR) or other documentation that shows the diagnosis/ICD-10 code.

Please note, this is a temporary workaround given the national health emergency. * The patient’s demographic information (including their Social Security number and date of birth) and their contact information * If the patient is a minor, you will need a guardian Social Security number as well. * The name of the diagnosis.

* Household financial income. * The name of the treating physician and his/her phone/fax numbers. * This information will not be shared and is for verification purposes only.

**Application Process:** There are two easy ways to register/apply: * By Phone: (877) 557-2672 Monday to Friday, 8:30 AM to 5:00 PM. * Online: Online portal, 24/7, Available in English only. If you do not have an LLS Financial Assistance Copay Portal Account, you will need to register before you can start the online application.

To create a portal account : * Complete the registration form in the LLS Financial Assistance Copay Portal and submit. * Receive confirmation email (typically within 5 minutes of submitting) and click on the link provided to create a password. * Log on to the LLS Financial Assistance Copay Portal using newly created password.

* Begin application process. All required fields must be completed. * Upon completing your application, submit for review.

## About This Organization The mission of The Leukemia & Lymphoma Society (LLS) is to cure leukemia, lymphoma, Hodgkin's disease, and myeloma, and improve the quality of life of patients and their families. **Updates due to COVID-19:** Due to COVID-19, LLS employees are currently working from home, and offices are closed. This tool is powered by Unite Us.

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