Get ready to apply
The Blood Cancer Foundation of Michigan
Patient Reimbursement Fund
What you get
Help with approved medical, transportation, and household expenses, prescriptions not covered by insurance, and transportation to treatment for patients and caregivers. Open now.
- Who starts it
- You
- How it’s sent
- Email to patientservices@bloodcancerfoundationmi.org
- Your time
- An hour or so
- Last checked
- Aug 27, 2026
Before you start, check you fit
- Only treatment-related expenses not covered by insurance are within the published reimbursement scope.
- Reimbursement is limited to qualifying treatment-related expenses not covered by insurance.
- Funding is subject to availability.
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What their form asksA preview, so you can gather things first. Fill it in on their site.
Open the application PDF ↗ Checked Aug 27, 2026Send it by email to patientservices@bloodcancerfoundationmi.org.
What the form asks for
Patient informationToday’s datePatient’s Last Name: First: MiddleMr. / Miss / Mrs. / MsMarital statusHome PhoneCell PhoneEmailCurrent Treatment StatusPreferred Method of ContactBirth dateAgeSexPatient isStreet AddressCityStateZipMichigan County of ResidenceRaceEmployment: (If patient is a child, please list parent/caregiver employment info)Veteran StatusHousehold Income Level: (For informational purposes only. Services are not based on income.)Medical & insurance informationDiagnosisDiagnosis DateBone Marrow/Stem Cell Transplant DateTreatment CenterCityStateHealth Professional ContactTitle/PositionPhone NoDoes the patient have insurance? (Please include Medicare/Medicaid)Primary Health InsuranceSecondary Health InsuranceShow the rest of the form (2 more sections)
Referral and caregiver informationHow did you hear about BCFM’s servicesName of Primary CaregiverRelationship to PatientAddress: (if different from patient)CityStateZipHome PhoneCell PhoneEmailShould this person be the primary contact instead of the patientAdditional family information, needs, and certificationTotal Number of People in Household: ChildrenTotal Number of People in Household: AdultsList Names/Birthdates of Children Still Living in Home (other than patient): Name / DOB / SexAny additional information on your current needsSignatureRelationship to PatientDateHave ready
- Completed and signed 2026 BCFM enrollment form.
After you send
Save a copy and delivery evidence; call (800) 825-2536 if confirmation is not received.