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Qualifying Patients

Qualifying patients in need

To qualify for financial assistance through MCCF, patients must have health insurance. This can be commercial—or through the Federal government, such as Medicare, Medicaid or TriCare. And they must be a US citizen and live in the US or Puerto Rico. If both are true, they may apply for MCCF assistance.

MCCF makes applying easy

At MCCF, we believe that the application process should not be a burden that requires a lot of time or paperwork. This is why we developed a user-friendly online application that is quick and easy to complete. It also allows for more efficient processing and reduces the use of paper, which is good for the environment.

How to apply for a patient

    To be considered for assistance, an application for our program must be fully completed. This involves completing a questionnaire for determining eligibility and providing the following documentation:
  • The patient’s most recent tax document to verify household income
  • A Statement of Medical Necessity that is completed by a physician or healthcare provider
  • Proof of health insurance coverage, whether it’s a commercial policy or Medicare, Medicaid or TriCare

To register a patient, download and complete the application, then fax it along with supporting documents to the fax number in the box at right. If you cannot download or fax the application form, call MCCF at 973.729.0087. A representative will take the information over the phone.