Bella Lisa Pancreatic Cancer Foundation
Guidelines for Financial Assistance

The financial assistance program is a program that has been put in place to assist those on Staten Island with pancreatic cancer to help cover basic cost of living expenses. We only provide assistance for necessary living expenses, please see below for more information on what we provide assistance for.

 

Assistance Program Purpose and Mission

The assistance program is made available to provide direct financial support for patients on Staten Island who are currently in treatment for pancreatic cancer. Our hope and wishes are to make the days less stressful by helping with expenses faced during this difficult time.

Any inaccurate information on your application may result in disqualification to receive financial assistance

 

Availability

Applicant must reside in Staten Island New York to be considered for financial assistance. Each applicant may apply once per month up to 3 months total. The committee reserves the right to distribute assistance amounts based on funds available at the time of the request.

Support Summary: Assistance is made available to both men and women diagnosed with pancreatic cancer through the Bella Lisa Pancreatic Cancer Foundation patient assistance program. You must be currently undergoing pancreatic cancer treatments to apply. The program is available due to the generosity of our donors and the volunteers who help with the fundraising events.

 

Policy

The policy is to guide the foundation and its committee in processing requests from pancreatic cancer applicants who have completed the application for assistance with Bella Lisa Pancreatic Cancer Foundation and have provided the proper documentation.

  1. The assistance program has the right to have an “open and closed” periods. If there is a period where the program is closed, notification will be done when patients call and will be posted on our website (coming soon).

  2. Each applicant may apply once a month, up to 2 months total... the committee reserves the right to distribute assistance amounts based on funds available at the time.

 

Requirements to Apply:

You must provide a copy of the following items

  1. Proof of US Citizenship. Copy of birth certificate or passport.

  2. Copy of Driver’s License or State Identification card.

  3. Proof of income for all adults residing in household (social security letter, paystub, etc.)

  4. Bank statements from all adults residing in household (3 months).

  5. A doctor letterhead signed by treating doctor advising you are currently in treatment for pancreatic cancer. Must be an original signature by the doctor, not a copy or a fax copy. (must be mailed to P.O. Box 100481 Staten Island New York, 10310)

  6. Rental agreement or lease (for those requiring assistance for rent)

  7. Provide copies of all of your bills you are requesting assistance with along with a letter of explanation regarding your current situation.

  8. The application must be completed in full, including submitting all required documents. Original signatures, No faxes or copies of doctor signatures will be accepted

  9. Have an annual household income of less than 200% of the national poverty level.

  10. Have no more than $5000 total liquid assets (cash, checking and or/savings, etc.)

 

** The following is a list of bills that will be considered through our financial assistance program:

1. Rent/mortgage

    (Mortgage cannot be in foreclosure or bankruptcy)

2. Phone

   (phone bills that include cable will not be considered, a breakdown of the actual cost of the                 phone line is required).

3. Electric/Gas/Water Bills

    Bills cannot be on an automatic payment system with the creditor. We do not offer

    reimbursement for any bills. Current statements with amount due must be submitted with

    application paperwork.

 

If you have been approved for assistance the following month you only need to provide us with new and current billing statements. You do not need to send in the entire application again.

Any misleading information provided in application will automatically terminate qualification

for financial assistance.

 

Important Facts

  1. You must be a US Citizen. Please do not apply if you cannot prove that you are a US citizen.

  2. Your application will NOT be processed or considered without the listed requirements.

  3. On occasion testimonials may be required by applicant at the approval committee’s request.

  4. Policies and application criteria are reviewed periodically and amended accordingly.

  5. We can’t accept applications from other organizations. You must submit the BLPCF application.

  6. We cannot process applications completed in a foreign language.

  7. Bella Lisa Pancreatic Cancer Foundation does not provide financial assistance for insurance company’s bills, hospital bills, co-pays, or collection accounts, credit cards, cable bills, or cell phone bills unless the cell phone is the main phone.

  8. We do provide assistance for rent/mortgage, utilities, and travel expenses for treatment, groceries, and other necessary living costs.

  9. Financial assistance is based on funds available at time of request and all criteria for guidelines must be met.

  10. We will contact you if we have any questions about your application. You are more than welcome to call us or email us to check the status of your application.