Requirements for Consideration:
- Have a recent head and neck cancer diagnosis:
- Oral Cavity (Mouth, tongue, palate, jaw, inner cheek)
- Pharynx (Throat, tonsil)
- Larynx (Voice box, glottis)
- Salivary Gland
- Nasal or Sinus
- Thyroid
- Upper third of the Esophagus
- NOTE: The following are not considered head and neck cancers and do not qualify for assistance: Cancers of the brain or eye; skin cancers on the face or scalp; middle/lower esophagus cancers (including adenocarcinoma of the esophagus and gastro-esophageal junction).
- Meet the program’s financial guidelines (200% of Federal Poverty Level):
| Household Size |
Income Threshold |
| 1 |
$31,920 |
| 2 |
$43,280 |
| 3 |
$54,640 |
| |
add $11,360 for each additional household member |
- Complete and submit an application including the following supporting documentation:
- Pathology report or clinic notes confirming a head and neck cancer diagnosis.
- Proof of income for the last 30 days for all members of the household.
Types of Financial Assistance Grants:
- Copayments:
- Must be required at the time of appointment.
- For diagnostic imaging such as PET and CT scans.
- Lodging, if treatment is further than 50 miles one way and have 2 or more consecutive days of appointments.
- Trach supplies, head garments and equipment not covered by insurance.
- Prescriptions and over the counter medication related to head and neck treatment, prescribed by a medical doctor.
- Oral nutritional supplements and tube feeding, prescribed by a medical doctor.
- Dental, we are able to assist with dental treatment plans in states where we currently have active grant funding. Please feel free to reach out if you would like to verify eligibility of your resident state before applying.
Ineligible expenses include:
- Expenses unrelated to the diagnosis, treatment, or recovery of head and neck cancer.
- Household and living costs, such as utilities, rent, mortgage and groceries.
- Personal and home maintenance expenses, such as car repairs and home modifications.
- Health and dental insurance premiums, including Cobra payments.
- Medical and dental expenses incurred prior to the application submission date.
Review of Applications and Payment of Grants:
- HNC Living Foundation does not provide emergency approvals for applications. Our staff diligently reviews, approves and provides grant payments to vendors within 14-21 days, depending on the request.
- Payment will be made directly to service providers or vendors for future services.
- No cash payments will go directly to the patient.
Apply for Individual Financial Assistance
