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Frequently Asked Questions
Q. What is the Cystic Fibrosis Patient Assistance Foundation (CFPAF)? A. The CFPAF is a non-profit organization that provides financial assistance to cystic fibrosis patients who need FDA-approved medications for inhalation and paired drug delivery devices for the , nebulizer treatment of cystic fibrosis. It was launched in response to the high cost of CF medications, and it is the only national patient assistance program designed specifically for the CF community. Our aim is to alleviate the financial burden costly medications have on CF patients and their families. Q. What services does the Cystic Fibrosis Patient Assistance Foundation offer? A. First and foremost, we offer financial assistance for CF medications and devices, by providing co-payment and co-insurance assistance for eligible medications and devices. We also provide insurance benefit verification, reimbursement support, case management, patient advocacy, and referrals to alternative assistance programs. Q. What if I am uninsured and have limited income; can the CFPAF help determine if I am eligible for a state or federal insurance program, or can the CFPAF help me determine if I am eligible for Social Security Income (SSI) or Social Security Disability Income (SSDI)? A. Yes, part of our case management services (CF Insurance Access Program - CFIAP) includes helping you determine if you are eligible for a state/federal insurance program; we can also assess whether you may be eligible for SSI or SSDI. If we determine that you are likely to qualify, our legal team will help you fill out all the necessary application materials to ensure the best chance of a favorable outcome. Q. How do I contact the CFPAF? What are the hours of operation? A. You may contact the CFPAF by phone at (888) 315-4154. Our hours of operation are Monday through Friday from 8:30 a.m. to 5:30 p.m. Eastern Time. You are welcome to leave a message during non-business hours, and we will return your call within one business day. You may also contact us via our website at: www.cfpaf.org, or send us an e-mail at: mthomas@cfserv.com. We look forward to hearing from you soon. Q. How do I apply to the CFPAF? A. To apply for assistance from the CFPAF, you will need to submit an application, along with the accompanying income and residency verification documents. To obtain an application, please call us at (888) 315-4154. We will ask you some screening questions to determine if you are likely to qualify. If so, we will send you an application. If you do not qualify, we may still be able to help you find other support services to meet your needs. If you prefer, you may also obtain a copy of our application from our website at http://www.cfpaf.org, by clicking on the link "Apply Now," and following the step-by-step instructions. Q. How long does the application process take? A. Once we receive your completed application and all necessary income and residency verification documents, we will begin to process and review your application. The processing time is approximately 5-7 business days. We will notify you by phone and mail once we have made a decision. You are welcome to call us and check on the status of your application at any time. Q. How can I check on the status of the application I sent to you? A. You can check on the status of your application by calling us at (888) 315-4154. Please remember that we will begin to process your application as soon as possible, but processing will take approximately 5-7 business days. Once a decision is reached, we immediately notify you of the results by telephone and by mail. Q. When and how will you notify me if I am accepted and enrolled in the CFPAF? A. If you are approved for assistance from the CFPAF, we will call to notify you of your enrollment on the same business day. We will tell you your identification number and enrollment date, as well as explain how the program works. We will also send you an enrollment kit, consisting of an enrollment letter and your CFPAF benefit card, which will be used to obtain your CF medications/devices at your pharmacy of choice. Q. If I am enrolled, how long is the enrollment period? A. Enrollment in the CFPAF is for up to one year. Three months before the end of this enrollment period, we will send you a re-enrollment application. This will allow enough time for you to reapply for assistance for the next year, without an interruption in support, provided that you continue to meet the CFPAF's eligibility criteria. Q. Do I need to fill-out an application to be enrolled? Or can I be enrolled over the phone? A. Yes, the CFPAF requires that you complete an application prior to enrollment. You will also need to submit income and residency verification with your completed application. The application contains instructions on the types of income and residency verifications that are acceptable. If you prefer, we can pre-screen you over the phone to determine if you are likely to qualify. However, you will still need to send us a completed application and accompanying documents prior to enrollment. Q. Can I apply on behalf of someone else? A. Yes, you may apply on behalf of someone else. You may also call the CFPAF on behalf of someone else. If you would like to call about a particular patient, please make sure you are listed as an authorized contact with the CFPAF. Due to privacy laws, we will not be able to provide you with any information regarding a particular patient unless you are an authorized contact. Q. For what CF medications do you offer assistance? A. The CFPAF provides support for the use of FDA-approved medications for inhalation and paired drug delivery devices for the nebulizer treatment of cystic fibrosis. You may also call us if you are taking another medication, and we will help you find other resources that may be able to offer assistance. Q. Do you cover the entire cost of my CF medications? A. The CFPAF covers the remaining cost of your approved medications and devices, after your other insurance coverage and assistance programs have paid. You will owe either nothing or a $10 co-payment per prescription. The amount of assistance we provide is based upon your existing insurance coverage, household income, and the number of CF patients in your family. Q. What happens if my physician changes my medication(s) during my enrollment period? Will I still be eligible for CFPAF assistance? A. As long as your physician switches you to an FDA-approved medication for inhalation or paired drug delivery device for the , nebulizer treatment of CF, we should be able to continue providing you with assistance. You will need to notify us of any change in your approved medications and devices, so that we can make the necessary changes to your CFPAF benefits. Q. How much financial assistance will you award me? A. The amount of assistance you will be awarded will vary depending upon your other insurance coverage and the approved medications and devices you are using. It will also depend upon your household income and the number of CF patients in your family. Q. Do you accept information by fax? A. Yes, the CFPAF does accept information via fax. Our fax number is (877) 868-5952. We recommend that you fax information to us whenever possible rather than using mail. The sooner you get your application and accompanying documents to us, the sooner we can start to review and process your application. Q. How do I know if I qualify? What are the eligibility criteria for CFPAF assistance? A. You will not know with certainty whether you qualify for assistance from the CFPAF until we process your application. However, to find out if you are likely to qualify you can either call us and ask to be pre-screened, or use the pre-screening tool on our web site. The eligibility criteria fir the CFPAF are: 1) you must have a diagnosis of CF, 2) you must be a permanent resident of the U.S., 3) you must be requesting support for a CFPAF eligible medication or device, 4) you must meet qualifying income criteria, and 5) you must have applied to or not be eligible for another co-payment foundation or patient assistance program (PAP). Q. Do uninsured patients qualify for CFPAF assistance? A. Uninsured individuals may qualify for assistance from the CFPAF. However, the CFPAF is the payer of last resort. Specifically, we will pay the remainder of a patient's copayment or coinsurance only after his or her insurance or any other assistance programs have paid. If you are uninsured, please call us, and we will determine if you are likely to qualify. We can also help you find other resources that may be able to better assist you. Q. Do patients without a CF diagnosis qualify for enrollment in the CFPAF? A. No, only patients with a diagnosis of CF currently qualify for assistance from the CFPAF. We will refer patients who do not meet our criteria to more appropriate alternative assistance programs. Q. What happens if I am over the income limit? What is the maximum amount I can make and still be approved in the CFPAF? A.The CFPAF can only offer assistance to patients who meet our income criteria. These criteria are adjusted for the number of people in your household, regional variations, and the number of CF patients in your family. Please contact us if you have additional questions about the CFPAF's income requirements. Q. Why do I need to send income documentation? And what income documentation do you need with my application? A. The CFPAF requires that you provide proof of income in order to show that you meet our eligibility criteria. Both the application and accompanying application checklist describe the different types of income documentation you can send with your application. Please call us, if you have questions about what forms income documentation are acceptable. Q. How can my pharmacy get reimbursed for my CF medications? How does the benefit card work? A. Your pharmacy can get reimbursed for approved CF medications and devices by electronically billing the benefit card that is enclosed with your CFPAF enrollment letter. The benefit card works like any other prescription drug card. The only difference is that the CFPAF is the payer of last resort, so the benefit card covers just the remaining cost of your prescriptions after all of your other insurance has been billed. With the CFPAF card, your pharmacy may collect a $10 co-payment for each prescription depending upon the amount of assistance you have been provided. If you or your pharmacist has any questions or problems using the CFPAF benefit card, please call the Welldyne help desk at (888) 886-5822, or the CFPAF at (888) 315-4154. Q. I just sent in a claim form. When will I get my check? A. We will complete the processing your claim form within 7 to 10 business days after being received. You should receive your reimbursement check shortly thereafter. We will contact you if we need any additional information to process your claim. You are welcome to call us to check on the status of your claim. Q. I do not wish to use the benefit card. How does the claim form work? And what do I need to send with the claim form? A. The benefit card provided to all CFPAF enrollees is the easiest and most efficient way to pay for your medications and devices without having to spend money out of pocket. However, if you and your pharmacy prefer not to use the benefit card, then you may submit a claim form instead. The CFPAF claim form includes complete instructions. Please call us, if you have any questions about the claims filing process. Q. Where does the CFPAF get funding? Who donates to the CFPAF? A. The CFPAF receives funding for patient assistance from various pharmaceutical manufacturers. In addition, the Cystic Fibrosis Foundation supports the CFPAF by contributing administrative support. Q. What happens when the end of my enrollment period is up? How do I reapply for more assistance? A. Three months prior to the end of your enrollment period, we will send you a re-enrollment application and letter explaining the re-enrollment process. You will then have 90 days to return the re-enrollment application, and the required income and residency documents needed to apply for assistance for the next year. Q. What happens if you run out of funding during my enrollment year? A. The CFPAF closely monitors the amount of assistance it commits to providing to enrollees and the contributions we receive. If we anticipate running out of funding, we will notify you well advance, and we will help you find other programs that may be able to offer assistance. Q. Which pharmacies accept the benefit card? How do I order my medication(s)/device(s)? A. The CFPAF can work with any pharmacy that agrees to accept the benefit card. The CFPAF may not recommend that you use any particular pharmacy, so it is up to you to select your preferred pharmacy. If you are unsure which pharmacy you should use, we have a list of pharmacies that we can provide to you.
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