The Cancer Foundation
of Northeast Georgia
PO BOX 49309
Athens GA 30604

3320 Old Jefferson Rd
Building 700
click here for map

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Financial Assistance Program (FAP)

Eligibility Criteria:

Applicants must meet the following qualifications to be considered for the FAP. 

  • Reside in the CFNEGA service area which includes: Banks, Barrow, Clarke, Elbert, Franklin, Greene, Habersham, Hart, Jackson, Madison, Morgan, Oconee, Oglethorpe, Putnam, Stephens,Taliaferro, and Walton counties.
  • Must be at least 18 years old. 
  • Have a cancer diagnosis as certified by healthcare provider.
  • Be receiving active chemotherapy and/or radiation, hormone therapy, or be within a 3 month post-treatment period.
  • Have household* income less than or equal to 200% of the 2011 Federal Poverty Limits.
Household Size Gross Monthly Income Gross Annual Income
1 $1,815.00 $21,780.00
2 $2,452.00 $29,420.00
3 $3,088.00 $37,060.00
4 $3,725.00 $44,700.00

*From Ga Dept of Community Health Financial Limits
5 $4,362.00 $52,340.00

*Household is defined as any persons residing together related by blood, marriage, commitment, or legal adoption that are dependent on the combined income.

  • Must be able to provide proof of income for each person in household over 18 years.  Choose one of the following items for  proof of income:
    • Bank statements from the last two months
    • Pay stubs from the last two months
    • Social Security benefit letter
    • Social Security 1099
    • Notarized statement from employer
    • Copy of Social Security check
  • If a patient has no income
    • Patient needs to provide a notarized letter stating the reason for no income.
  • Have resources** totaling less than   
    • $9,000 (single individual)
    • $12,000 (couple)

      **Resources Include:

      **Resources do not include:
      1. Checking Accounts and/or cash
      2. Savings/Money Market Accounts
      3. Stocks/Bonds
      4. CDs
      5. Mutual Funds/Taxable Annuities
      1. Primary residence
      2. Two automobiles
      3. Retirement Accounts
      4. Personal Possessions
    • $15,000 (family)




  • Demonstrate attempts to apply for other forms of community financial assistance.
    • List other agencies from which you have requested funding. 
  • Financial assistance will be considered for applicants that meet the aforementioned qualifications
  • Financial assistance  will be awarded to assist with the following expenses:
    • Utility bill(s) including gas, electric, water, propane and phone. Utility bills must be due within a week of the financial request or past due.
    • Rent/mortgage payments must be due within a week of the financial request or past due.
    • Insurance Premiums (COBRA included)
    • Health insurance co-payments
    • Nutritional  Assistance 
    • Durable medical equipment not covered by insurance, i.e., walkers, wheelchairs, bedside toilets, etc.
    • Pharmacy prescription costs
    • Transportation cost (gas cards)
  • Payments will be made directly to company owed. Therefore  applicants must supply copies of the bill, late notice, mortgage statement, statement from landlord and his/her contact information, or any additional information necessary for grant payment.
  • There is an annual cap of $500.00 per applicant (Amount may vary based on availability of funds)
  • Applicants must wait one year to reapply for financial assistance.
  • Applicants must be referred by a physician, physician assistant, nurse, social worker, or patient account representative.
  • Only completed applications will be considered.

Referral:

The Financial Assistance Program is based on a referral system. A patient must be referred by a social worker, nurse, physician, physician assistant, or patient account representative.

Click to download referring professional form.

Application:

Referring professionals are asked to mail a completed application to the following address or fax number:

The Cancer Foundation of Northeast Georgia
P.O.Box 49309
Athens, GA 30604-9309
Or  Fax to (706) 353-4353

Click to download Application Letter.

Click here to download Application Form.

Click here for the CFNEGA Financial Distress Screening.

Application Process:

  • Applications are reviewed by The Cancer Foundation’s staff for completeness and whether the patient meets eligibility criteria. 
  • If the patient is approved for assistance the referring professional is notified by phone or email regarding the amount of assistance. 
  • Financial Assistance checks are made directly to the creditor owed.

What we fund:

Financial assistance  will be awarded to assist with the following expenses:

  • Past due gas, electric, water, propane and phone
  • Past due rent/mortgage
  • Insurance Premiums (COBRA included)
  • Health insurance co-payments (does not include deductibles) 
  • Nutritional  Assistance 
  • Durable medical equipment not covered by insurance, i.e., walkers, wheelchairs, bedside toilets, etc.
  • Pharmacy prescription costs