Medical Grant Assistance Application
Dollars for Mammograms Medical Assistance Grants were established to assist our recipients, who have gone through appropriate testing and need further testing for diagnosis or for medical bills incurred during treatment.
- The Applicant must be a Dollars for Mammograms, Inc. recipient and may submit a grant application within 12 months from the date of biopsy. Uninsured, underinsured or cannot afford recipients are eligible to apply.
- Applicant must attach a brief statement of financial need.
- Applicant must submit copies of breast health related testing or procedural medical bills for which they are requesting grant money.
- The Applicant must be screened for ACA Insurance within the ACA enrollment period that applies to them.
- Applicant is required to submit a copy of their health insurance marketplace eligibility notice from the ACA screening.
- If enrollment period is not open to the Applicant they must attach a current tax return to establish financial need.
- If Applicant is one of our underinsured recipients, they may apply for a grant, but must provide current tax return to establish financial need.
- Grant will be paid directly to the medical service provider upon approval. Grantee will be notified of payment to provider.