Hooked on Hope Treatment Support Grant Application Guidelines

As of 6/1/2022

Serving ALL Tampa Bay, Florida Communities

Hooked on Hope is a 501(c)(3) State of Florida non-profit organization; EIN #26-1986514. Hooked on Hope was founded in 2009. The organization raises funds for breast cancer patients across all Tampa Bay Communities. The purpose of the Treatment Support Grants Program is to provide short-term financial assistance for un-insured and under insured breast cancer patients during treatment. Patients must meet eligibility criteria and complete an online application – submitting all required backup documentation. Grants are provided based on the current availability of funds. Incomplete grant applications will not be processed.

Hooked on Hope provides financial assistance for:

  • Doctor office visit co-pays
  • Hospital co-pays
  • Treatment visit co-pays (i.e. chemotherapy, radiation, or lymphedema therapy)
  • Essential living expenses such as rent/mortgage, utilities, telephone, auto payments, and auto insurance

Hooked on Hope is unable to pay for:

  • Medical bills
  • Credit card bill
  • Tax bills

Hooked on Hope does not provide cash grants directly to patients. Funds are provided as one-time, per patient grant award. Per patient funding amounts vary on a case-by-case basis, however usually range between $1,500 and $3,000. Hooked on Hope reserves the right to adjust per patient funding amount on a case-by-case basis and current availability of funding. All applicants are encouraged to develop a long-term plan; and to utilize all other community resources available. Hooked on Hope maintains a ‘Patient Resource List’ available upon request and found at www.hookedonhope.org.

To qualify, an applicant must:

  • Be 18 years or older
  • Be a current resident in a Tampa Bay Community.
  • Be currently receiving treatment for breast cancer in a Tampa Bay Community.
  • Have no greater than $3,000 in liquid assets (cash, checking, savings)
  • Prove a decrease in household income as a direct result of breast cancer treatment and/or……….
  • Prove an increase in household expenses as a direct result of breast cancer treatment and/or ………
  • Prove adverse affective as direct result of job loss due to Covid Pandemic.
  • Although the organization does NOT provide emergency funding, patients with eminent housing issues will be given priority.

How to Apply:

  • Complete the web-based application.
  • Understand and electronically sign the ‘Release.’
  • Upload required documentation (listed below) at the time of your initial application – documents will not be received piece-meal or accepted after the submission of your application!

Documentation to Upload:

  • Driver License or Photo ID.
  • Proof of household income (pay stub, letter from employer, IRS Tax Return, Social Security/Disability Letter).
  • Copies of bills for which financial assistance is requested (to include rental agreement or mortgage statement).
  • Three (3) most recent bank statements.
  • IRS Tax Return may be required.
  • Proof patient is undergoing breast cancer treatment (letter from treating doctor, office note or pathology report).

Important Notifications:

  • Application must be completed in its entirety, to include upload of required documentation.
  • Documentation must be properly uploaded once. Documents will not be received ‘piece meal.’
  • Incomplete applications will NOT make their way to Grants Committee for review.
  • Grant Committee Members are confidential for the protection of the applicant.
  • Must allow up to thirty (30) days for application review. Payments may take up to 30 days to process.
  • · Applications will be reviewed without bias based on age, race, county of residence, or treating physician(s).
  • The basis of determination by the Grants Committee will be available, in writing upon request.
  • Applications will remain open for no greater than thirty (30) days from date of receipt.

Release and Terms of Agreement:

I certify that all the information I have provided is true, complete and correct. I expressly authorize, without reservation, the Hooked on Hope Breast Cancer Treatment Support Grants Program and its advisors or representatives to contact and obtain information in order to verify the accuracy of information provided by me in this application. I understand that I will be required to provide backup documentation to Hooked on Hope or its representatives in order to verify the information provided herein. I understand that any information that may not be verified, is incomplete, or is misrepresented in any respect will be sufficient cause to eliminate me from consideration for financial assistance and will result in the denial of this application.

Do not sign until you have read the above application statement. I certify that I have read, fully understand and accept all terms of the foregoing application statement: I understand that my application may not be submitted to the Hooked on Hope Grants Committee for consideration unless it is completed in its entirety and required/requested backup documentation has been provided.