Payment Assistance

Georgia Department of Community Health
Services
Cancer State Aid

Contact Information
Cancer State Aid
2 Peachtree Street
16th Floor
Atlanta, GA 30303
(404) 463-5111
www.health.state.ga.us

Georgia Department of Human Resources and Georgia Department of Community Health Services
Services
Women's Health Medicaid Program (WHMP)

Contact Information
(404) 657-6611
www.health.state.ga.us/programs/womensmedicaid

Genentech - Roche Group
Services
Commitment to Patient Access

Contact Information
(866) 4 ACCESS
www.genentechaccesssolutions.com

GlaxoSmithKline (GSK)
Services
Prescription Drug Assistance

Contact Information
Commitment to Access
P.O. Box 29038
Phoenix, AZ 85038-9038
(888) 825-5249

Health Well Foundation
Services
Financial assistance to eligible individuals to cover coinsurance, copayments, healthcare premiums and deductibles for certain treatments

Contact Information
(800) 675-8416
www.healthwellfoundation.org

Merck
Services
Patient Assistance Program

Contact Information
Patients (800) 727-5400; Healthcare Providers: (800) 994-2111

National Council on the Aging
Services
Benefits Check up

Contact Information
www.benefitscheckup.org

Needy Meds
Services
Information about many drug assistance programs

Contact Information
www.needymeds.org

Patient Access Network Foundation
Services
Prescription assistance to underinsured patients

Contact Information
(866) 316-7263

Partnership for Prescription Assistance
Services
Medications available for reduced or no-cost assistance

Contact Information
(888) 477-2669
www.pparx.org

Pfizer
Services
First Resource Program

Contact Information
(877) 744-5675
www.pfizerhelpfulanswers.com

Rx Assist
Services
Patient Assistance Program Center

Contact Information
(401) 729-3284
www.rxassist.org

The Association of Community Cancer Centers
Services
2012 Patient Assistance and Reimbursement Guide

Contact Information
www.accc-cancer.org

The Patient Advocate Foundation (PAF)
Services
Co-Pay Relief Program (CPR)

Contact Information
(866) 512-3861
www.copays.org

Together Rx Access Card
Services
Prescription assistance resources

Contact Information
www.together-rxaccess.com

Patient Services Incorporated (PSI)
Services
Provides financial assistance programs cancer patients. Immediate coverage for person with medical history/conditions without a waiting period. Services include breast cancer screenings.

Contact Information
PO Box 5930
Midlothian, VA 23113
(800) 366-7741
www.patientservicesinc.org

Rx Outreach
Services
Rx Outreach is a fully-licensed mail order pharmacy that is committed to making the use of prescription drugs safer and more affordable. Rx Outreach is not a prescription insurance program nor an Internet pharmacy. Rx Outreach was developed to provide a safe, affordable, and easy way for people of all ages to get medicines they need. The program offers prescription medicines to uninsured and underinsured individuals and families, as well as those who have limited prescription drug coverage.

Contact Information
P.O. Box 66536
Saint Louis, MO 63166
(800) 769-3880
www.rxoutreach.org

Sue Kassin Memorial Indigent Fund
Services
Find answers – Take action – Get Support. Payment assistance for qualifying women diagnosed with gynecologic cancers.

Contact Information
Janet Kempe
jkempe@lycos.com
www.forthewomenwelove.org

Sue Kassin Memorial Indigent Fund
Services
Find answers – Take action – Get Support. Payment assistance for qualifying women diagnosed with gynecologic cancers.

Contact Information
Janet Kempe
jkempe@lycos.com
www.forthewomenwelove.org

Glory, Hope & Life
Contact Information
770-533-4705
www.gloryhopelife.org

Glory, Hope & Life
Services
Offers financial assistance for travel, groceries and utilities. Also offers financial assistance for wigs and breast forms.

Contact Information
770-533-4705
www.gloryhopelife.org

Hope Center Foundation
Services
The Hope Center Foundation removes barriers to care by offering assistance with medication, transportation, and rent/utilities, among others.

Contact Information
Wendy Bailey, RN
678-721-5508

Loving Arms Cancer Outreach
Contact Information
Diana Hurst
678-721-5567

Cartersville Medical Center Financial Counselors
Contact Information
Theresa Waddell
Debbie Howard
770-382-1530 ext. 1055 or 770-382-1530 ext. 1115

XTANDI Support Solutions Overview
Services
XTANDI Support SolutionsSM, a component of Astellas Pharma Support SolutionsSM, offers services to help patients and healthcare providers with access and reimbursement. Whether you elect to go directly to one of the specialty pharmacies in our network or to XTANDI Support Solutions, reimbursement services focused on drug coverage and payer-specific requirements are available. XTANDI Support Solutions provides information regarding patient healthcare coverage options and financial assistance programs to help patients with financial needs. This assistance includes: • XTANDI SUPPORT SOLUTIONS PATIENT ENROLLMENT FORM • BENEFITS VERIFICATION • PRIOR AUTHORIZATION ASSISTANCE • APPEALS ASSISTANCE WITH DENIED PRIOR AUTHORIZATION REQUESTS • XTANDI QUICK START+™ PROGRAM • PATIENT ASSISTANCE • SPECIALTY PHARMACY COORDINATION

Contact Information
Astellas Pharma US, Inc.
1 Astellas Way
Northbrook, IL 60062
1 (800) 888-7704
https://www.astellaspharmasupportsolutions.com

Financial Advocacy Network
Services
The Financial Advocacy Network (FAN) provides needed resources and expands the skills and knowledge base of providers who deal directly with patients on complex financial issues surrounding their cancer diagnosis and treatment. Tools and resources include skill-based educational materials for program staff currently providing financial counseling, as well as those new to financial advocacy.

Contact Information
Association of Community Cancer Centers
11600 Nebel Street, Suite 201
Rockville, MD 20852
301-984-9496
www.accc-cancer.org/resources/FinancialAdvocacy-Overview.asp

Organization-Specific

Many cancer centers, programs and practices offer financial assistance to their patient population. Please check with your cancer treatment site to see if payment assistance is available.

Statewide

Cartersville Medical Center Financial Counselors
Contact Information
Theresa Waddell
Debbie Howard
770-382-1530 ext. 1055 or 770-382-1530 ext. 1115

Leukemia & Lymphoma Society, Georgia Chapter
Services
Copay assistance to blood cancer patients

Contact Information
(877) 557-2672, (404) 720-7807
www.lls.org

Albany

Phoebe Putney Memorial Hospital
Services
Financial Assistance

Contact Information
417 Third Avenue
Albany, GA 31701
(229) 312-7141
www.phoebeputney.com

Phoebe Putney Memorial Hospital
Services
Phoebe Care Card

Contact Information
417 Third Avenue
Albany, GA 31701
(229) 312-4220 or (800) 514-0015
www.phoebeputney.com

Athens

Athens Regional Medical Center
Services
Medication Assistance, Utility Assistance, Lymphedema Garment Assistance

Contact Information
(706) 475-4900

The Cancer Foundation of Northeast Georgia
Contact Information
Kimberly I. Liebowitz
P.O. Box 49309 or 3320 Old Jefferson Rd,
Athens, GA 30604
(706) 353-4354
kliebowitz@negacancer.com
www.cancerfoundationofnega.org

Atlanta

Emory Winship Cancer Institute
Services
Oncology Resource Coordinator

Contact Information
1365C Clifton Road
Atlanta, GA 30322
(404) 778-5742
www.winshipcancer.emory.edu

Georgia Cancer Center for Excellence at Grady Health System
Services
Payment assistance

Contact Information
Grady Hospital
80 Jesse Hill Jr. Drive SE
Atlanta, GA 30303
(404) 489-9000
www.gradyhealthsystem.org

Northside Hospital
Services
Financial counseling

Contact Information
1000 Johnson Ferry Road
Atlanta, GA 30342
(404) 851 8000
wwww.northside.com

Augusta

University Hospital Breast Center and Cancer Services
Services
Financial assistance

Contact Information
1350 Walton Way
Augusta, GA 30901-2629
(706) 722 9011
www.universityhealth.org

Lawrenceville

Gwinnett Breast Care Center
Services
Payment assistance

Contact Information
1000 Medical Center Boulevard
Lawrenceville, GA 30046
(678) 312-1000
www.gwinnettmedicalcenter.org

Macon

Central Georgia Cancer Care
Services
Financial Aid Counselor

Contact Information
1062 Forsyth Street
Suite 1B
Macon, GA 31201
(478) 743 7068
www.centralgacancercare.com

Rome

Floyd Medical Center
Services
Financial assistance

Contact Information
304 Turner Mccall Boulevard Southwest
Rome, GA 30165
(706) 509- 5000
www.floyd.org

Savannah

St. Joseph's/Candler
Services
Financial Assistance Program

Contact Information
5353 Reynolds St.
Savannah, GA 31405
(912) 819-8455 or (800) 374-7054
www.sjchs.org

Valdosta

Pearlman Cancer Center
Services
Payment assistanc

Contact Information
2501 N. Patterson Street
P.O. Box 1727
Valdosta, GA 31603-1727
(229) 259-4638
www.sgmc.org