Financial Assistance Program
The Hemophilia Association of San Diego County (HASDC) provides financial assistance to individuals or families who are affected by bleeding disorders. These funds are to be used for immediate and severe medical needs that impact one’s health, safety or well being that are directly related to their disorder and not covered by insurance.
Any individual requesting assistance must complete a Financial Assistance Application describing the nature of the emergency, the amount requested, copies of related bills or estimates and compelling evidence that the need is indeed emergent.
To be eligible for this program, applicants must meet the following criteria:
Applicant must be an active member of HASDC. An active member is defined as an individual who is in the HASDC database and has a bleeding disorder or a parent/caregiver of a minor child, with a bleeding disorder, who lives in your home.
Resident of San Diego/Imperial Counties or receives treatment for bleeding disorders at one of the two San Diego treatment centers – Rady Children’s Hospital HTTC or UC San Diego Health HTTC.
You must complete all sections of the application thoroughly and accurately. If a question does not apply, it should be marked Not Applicable [N/A].
Exceptions: HASDC employees and members of the HASDC Board of Directors are not eligible for financial assistance.
Financial assistance is dependent on the availability of funds and applicant eligibility. Submitting a request does not guarantee funding. Applicants should allow at least two weeks for HASDC to process their request. Please do not inform creditor of payment until application has been approved.
Assistance is limited to a maximum of $500 per calendar year. HASDC assistance is limited to two consecutive years. After two years, applicants must wait one year before applying again for assistance. In the presence of special circumstances, the HASDC Board of Directors will review exceptional requests.
Disbursements will be made only to creditors identified in the application and that have been verified by HASDC. No payments will be made directly to applicants.
1. Completed applications and a copy of the bill in question must be submitted by mail to:
Hemophilia Association of San Diego County
3550 Camino Del Rio North, Suite 105
San Diego, CA 92108
or emailed to firstname.lastname@example.org
2. HASDC will review applications for completeness, check references, and consider the date the funds are needed in order to determine the urgency of the request.
3. Applications should be submitted directly to the HASDC office by the applicant. If this is not possible and it is necessary for another person to submit the application on behalf of the applicant, HASDC representatives will contact the applicant before the application will be processed.
4. HASDC strongly encourages applicants to coordinate their request with the social worker (or nurse coordinator) at their hemophilia treatment center or other healthcare provider treating bleeding disorders.
5. Incomplete applications will be returned to the applicant with an explanation of why it was returned and a description of the information still required.
6. If the application is approved, HASDC will notify the applicant and payment will be issued to the creditor identified on the application.
7. If the application is rejected, HASDC will notify the applicant with an explanation.
8. HASDC will update its Financial Assistance Program records and add the applicant to the HASDC database for future communications.
9. Please note: HASDC employees or members of the Board of Directors cannot be used as references in the Reference section of the application. If one of these individuals is mentioned, the application will be considered incomplete.
Applications and information pertaining to funding requests are considered confidential. Information from HASDC’S Financial Assistance Program applications may be compiled for statistical purposes, and for compliance with local, state, federal or affiliate organization requirements. However, any publication of this data will be in aggregate form only, and will not include names or any other information that could be used to identify individual applicants or recipients. No personal information will be used or disclosed for any purpose other than that for which it was collected. At no time will personal information be shared with any individual, company or organization outside of HASDC.
FINANCIAL ASSISTANCE APPLICATION
We are currently updating our Financial Assistance Application, please check back.