To be considered for the ABTA Financial Assistance Program, the patient must:

• Have a primary brain or spine tumor
• Reside in the United States (50 states and US territories)
• Have a yearly household income that is equal to or less than 400% of the US Federal Poverty Guidelines

Awarded grants are between $250 and $1000. The amount awarded depends upon the number of applications received by the ABTA and the current available funds. Financial assistance grants are awarded on a first-come, first-served basis to the extent funding remains available.

Bills that the program commonly covers include the following: rent/mortgage, medical, utility, cell phone and internet, auto/home insurance, and auto payments.

The program does not cover credit card bills. It also does not cover expenses without a bill, such as groceries or gasoline.

Any expense submitted for consideration must have supporting documentation.

To be considered, applicants must complete and submit ALL the following items:

• Completed application form
• Medical Provider form — The patient’s medical provider must complete this form
• Proof of household income (in PDF format)
  • The first two pages of a signed copy of the 1040 income tax return for the past two years (redacted social security numbers) for all non-dependent household members. If a household member does not file tax returns or has had a change in employment, submit three months’ worth of copies of paychecks/stubs; unemployment checks; or social security, public assistance, and other benefit notifications.
  • If the patient is a minor, financial records of parent(s)/guardian(s) must be submitted.
•  Copies of bills (in PDF format)
  • Copies of up to two current bills the patient requests be paid. The account number and the vendor’s name and mailing address must be included. Bills must be recent (issued within the past 60 days).
  • If the patient requests help with rent, a signed copy of the rental lease that includes the patient’s name, amount of rent, account number, landlord’s or property manager’s name, and mailing address where payments are made must be submitted.
• Medical information
  • A copy of the patient’s pathology report (if biopsy/surgery was performed) with the tumor type clearly stated. Other medical documentation is suitable if a biopsy/surgery was not performed, such as an MRI report or provider’s clinical note.

Please complete the online form below. You can save and return to it if you can’t finish it all at once. Please upload the required documents (proof of household income, copies of bills, medical information) at the end of the online form where requested.

If you prefer not to complete the application electronically, you can download and complete the PDF and send to the ABTA in one of the following ways:

• Email: Please email financialassist@abta.org and attach the financial assistance application PDF and all required documents (medical provider form, proof of household income, copies of bills, medical information).
• Fax: Please fax the financial assistance application and all required documents (medical provider form, proof of household income, copies of bills, medical information) to 773-577-8738
• Mail: If you are mailing the application, please send the application and all other required documents (medical provider form, proof of household income, copies of bills, medical information) to:

American Brain Tumor Association
Attn: Financial Assistance Program
8550 W. Bryn Mawr Ave, Ste 550
Chicago, IL 60631

Applications must be received in their entirety no later than the 15th to be considered for that month (except for December, when the deadline to receive everything is the 5th).

Submitting a completed application by the deadline does not guarantee that an applicant will receive a grant. Grants are awarded based upon the number of grant applications received by the ABTA and the current available grant funds. ABTA will send the applicant an email when the applicant’s application is received and let that person know if more information is needed. The applicant is encouraged to add FinancialAssist@abta.org to their contact list. Adding ABTA’s email address to a contact list will help ensure that our communication does not end up in a junk mail folder, preventing the application from moving forward in the review process.

Have any other questions? Contact the ABTA at FinancialAssist@abta.org or call 800-886-2282.