The Financial Assistance program is part of the Nebraska Chapter of the National Bleeding Disorders Foundation’s continuing effort to improve the quality of life of individuals and families affected by bleeding disorders by providing financial support. The Financial Assistance program is supported by generous contributions from individuals, foundations, and corporations committed to the bleeding disorders community.

Example eligible expenses include, but are not limited to, the following:

• Expenses incurred in the care, treatment, or prevention of a bleeding disorder
• Transportation services to medical appointments and HTCs
• Medical supplies not covered by insurance
• Basic living expense emergencies (rent, mortgage, utilities, food, etc.)
• Unexpected home or car repairs
• Medic Alert Bracelets
• Dental expenses
• Health insurance premiums
• Funeral expenses

NOTE: This program is intended to help individuals and families after other sources of assistance have been exhausted or unavailable. Every effort should be made to utilize other community resources such as social services, food banks and other organizations that routinely meet these types of needs. There are additional agencies within the state, and nationally, that may also be able to provide financial assistance. For more information on these, please contact the Chapter or your HTC.

ELIGIBILITY

Prospective applicants will need to meet the following criteria:

• Be a constituent that resides in the territorial jurisdiction of Nebraska Chapter of NBDF or receives treatment for an inherited bleeding disorder at any of the area Hemophilia Treatment Centers (HTCs).
• All applicants must be 18 years of age or older. Applicants can be a parent or caregiver of a minor child who lives in your home and who has a diagnosis of a bleeding disorder OR be an individual with a diagnosed bleeding disorder.
• Complete all sections of the application thoroughly and accurately. If a question does not apply, it should be marked not applicable (n/a). Failure to provide complete and truthful information may result in denial of your request.
• Nebraska Chapter of NBDF must determine that the applicant qualifies for financial assistance pursuant to its Financial Assistance Policy in order to review the request.
• Nebraska Chapter of NBDF recommends that applicants request assistance from at least two (2) other agencies before applying to the Nebraska Chapter of NBDF for funding.
• If possible, coordinate request with the social worker, nurse coordinator, or medical provider at a hemophilia treatment center (HTC) or other healthcare provider treating inherited bleeding disorders.
• Applicant must sign the application to indicate an intended use agreement stating that the financial assistance received from the Nebraska Chapter of NBDF will be used for the purpose indicated on approved financial assistance application.

ADMINISTRATION

Financial assistance approvals depend on the availability of funds and the applicant’s eligibility. Funding is not guaranteed. Payment of funds upon approval also cannot be guaranteed earlier than 7 to 10 business days, and may take longer, from the date of the request due to the approval process.

Assistance is limited to a maximum of $500 per calendar year, with a minimum of 3 months between requests, per household, which also includes claimed dependents. Under unique circumstances, request(s) above the $500 limit must receive special approval by the Nebraska Chapter of NBDF, the Advisory Board, and/or Financial Assistance Committee. For funding above $500, Nebraska Chapter of NBDF may require that applicants request assistance from at least two (2) other agencies before applying to the Nebraska Chapter of NBDF.

If the same household, including claimed dependents, has requested and been granted assistance for three (3) consecutive years, they will be informed that they are ineligible to access the program for the next calendar year following their last request of the three (3) consecutive year period. In the presence of special circumstances, appeals of the three consecutive year policy shall be made to the Nebraska Chapter of NBDF Board of Directors and/or Financial Assistance Committee to review and approve exception requests.

Nebraska Chapter of NBDF cannot provide funding directly to the individual applicant(s). Disbursements will be made directly to vendors identified in the application that have been verified by the Nebraska Chapter of NBDF. In the case of a request for food, the requesting staff person will facilitate expenditure without giving cash directly to the client, and applicant must sign an Intended Use agreement stating that the financial assistance received from the Nebraska Chapter of NBDF will be used for the purpose indicated on approved financial assistance application.