Direct Patient Assistance Program

Helps with the cost of medical care

Direct Patient Assistance Program for Myasthenia Gravis

If you are a myasthenia gravis patient and are suffering because of the high cost of medical treatment and prescription medication, Conquer Myasthenia Gravis may be able to provide some relief. Conquer MG will cover the cost of medical treatment, durable medical equipment, and medication up to $1,000 per year per person, to the extent funds are available.

These costs do not need to be directly related to treatment for myasthenia gravis but may be for any medical treatment or prescription drug cost you have incurred.

Download the Application

Who is Eligible

You qualify if you meet all of these conditions:

  • You have myasthenia gravis
  • You are a resident of Illinois, Indiana, or Wisconsin
  • You have a financial hardship that makes it difficult or impossible for you to pay medical expenses not covered by insurance

How the Program Works

For hospital, doctor visit, medical procedure, or durable equipment charges, submit bills after all insurance payments are applied. Examples of durable medical equipment are wheelchairs, chair lifts, and oxygen equipment.

  • If you’ve not yet paid your portion of the bill, Conquer MG will pay the healthcare provider for approved charges.
  • If you’ve already paid your healthcare provider, send us health care provider receipts that reflect your payment as well as the amount covered by insurance, and any approved payment will be made to you.

For prescription costs that you pay out of pocket, collect your pharmacy receipts. Once you have $200 or more in paid receipts, submit them to the Patient Assistance Program and reimbursement (up to plan limits) will be mailed to you.

You may include medical bills and receipts for prescriptions and durable medical equipment in the same application. The total amount of these bills that will be paid by the plan in one year is $1,000 per person. You may reapply in future years if the program is continued.

To the extent possible, we encourage you to bundle your bills, and apply for at least $200 at a time. If you qualify for reimbursement, it does not guarantee that funding will be available for a later request.

Please complete the downloadable Patient Application and submit it along with your supporting documentation to Conquer MG.  The supporting documentation should confirm you are experiencing a financial hardship and are having difficulty paying your medical bill(s).  You also will need to have your physician (neurologist or general practitioner) complete the Physician Confirmation Form. You can return this form with your application, or your physician can mail it directly to Conquer MG.

We will review your application upon receipt and let you know if any additional information is needed. We will contact you, generally within 10 business days after receiving your completed information, to tell you of the decision regarding your request for assistance. Any payment will be made shortly afterward.

Please note your information will be kept confidential; access will be limited to the review committee.

If you have any questions about the application process, call the Conquer MG office at 800.888.6208. The decision made by Conquer MG regarding each completed application for payment will be final.

Information on this page updated September 2016.