Application Info

The HOPE CHEST for WOMEN helps patients with significant financial need defray treatment- related expenses including; incidental costs not covered by other assistance programs, transportation, supplements, lymphedema garments, testing approved medications, chemotherapy, and radiation therapy not covered by insurance or other sources.


Through this program, financial assistance, relevant education, and support services are offered to medically underserved women who are in need of support during treatment for cancer.

Who is Eligible for Assistance?

You may qualify for assistance through the Hope Chest Assistance Program if you:

  • reside in western North Carolina

  • are a woman receiving treatment for breast cancer

  • are you receiving treatment for cervical, endometrial, fallopian tube, ovarian, uterine,

  • vaginal, or vulvar cancer

  • are uninsured, underinsured, or need financial assistance

  • must provide doctor pathology report

If you have private insurance, you may receive aid for treatment-related costs that are not covered through other payment sources. Other eligibility requirements might apply.

All Required documents must be submitted with your application to receive assistance. Please send all of these items listed below in order to expedite your application.

  • Hope Chest Application

  • Information Release Statement

  • Income Statement is needed from every applicant (Copy of recently filed taxes, most recent pay stub, retirement or disability statement or bank statement) Level of income will not disqualify you for help. 

  • Pathology Report and Progress Notes

  • Letter of Medical Necessity, if applicable

  • A copy of bill(s) with payment instructions must be sent to us in order to provide bill pay assistance, payment could take over two weeks for approval.

Submit your application to: 

The Hope Chest for Women

P.O. Box 5294

Asheville, NC 28813

Your application will be approved after all supporting documents are submitted. Payments will be made to providers of service (i.e. pharmacy, lab, hospital, and physician). Funds are subject to availability. A new application is required every calendar year with supporting documentation. You will be given additional resource referrals based on your individual needs.


All decisions for disbursements to eligible patients are at the discretion of The Hope Chest board.

  

 

Get a copy of the Application

For a PDF version, please click below. We can also mail you the application if needed by calling (828) 708-3017 or emailing director@hopechestforwomen.org.

 

Contact Us

Hope Chest for Women
PO Box 5294
Asheville, NC 28813

Phone 828/708-3017

Fax 828/348-6164

Email Director@HopeChestForWomen.org