Patient Assistance Program

Patient Assistance Program
The cost of the test may be reduced for patients who qualify for our Patient Assistance Program (PAP). To be eligible, patients must meet the following criteria:
- Live in the United States or a U.S. Territory
- Have insufficient insurance coverage to pay for the test
- Meet income guidelines as detailed in the table below
- Complete a PAP application - English
- Complete a PAP application - Espanol
Patients should expect to be notified of their status within two weeks of submitting the completed application form. If the application is approved, patients may elect to pay the full amount or opt to set up an interest-free payment plan for up to 6 months.
To apply, please complete the PAP application and submit via fax to 617-649-4308 or mail to Exosome Diagnostics, 266 Second Ave., Suite 200, Waltham, MA 02451.
Household Income Eligibility Guidelines
Size of Household |
Income Level 1 | Income Level 2 | Income Level 3 | Income Level 4 | Income Level 5 | Income Level 6 | Income Level 7 | Income Level 8 |
---|---|---|---|---|---|---|---|---|
1 | $12,760 | $25,520 | $38,280 | $51,040 | $63,800 | $76,560 | $89,320 | $102,080 |
2 | $17,240 | $34,480 | $51,720 | $68,960 | $86,200 | $103,440 | $120,680 | $137,920 |
3 | $21,720 | $43,440 | $65,160 | $86,880 | $108,600 | $130,320 | $152,040 | $173,760 |
4 | $26,200 | $52,400 | $78,600 | $104,800 | $131,000 | $157,200 | $183,400 | $209,600 |
Out of pocket costs |
$50 | $75 | $100 | $125 | $150 | $200 | $250 | $300 |
If you live in Alaska or Hawaii or have a household greater than 4 members, please call 844-396-7663, option 3.
If you do not qualify for the PAP Program, we offer an interest-free payment program.
Please call 844-EXOSOME, Option 3 to learn more
*2020 poverty guidelines are in effect as of January 17, 2020. ExosomeDx follows poverty guidelines as set by the U.S. Department of Health and Human Services. Current guidelines can be found at aspe.hhs.gov/poverty-guidelines. Income levels are subject to change at any given time. Higher income levels not represented in this chart are associated with proportional out-of-pocket costs per our billing policy.
Income Verification
To apply, patients submit a completed PAP application form and provide at least one supporting document in the form of pages 1 and 2 of your previous year’s tax return (form 1040 or 1040EZ), wage and tax statements (W-2 or 1099), two recent paycheck stubs, social security, pension or railroad retirement statements (SSA-1099 or similar), statements of interest, or other income (1099-INT, 1099, 1099-DIV or similar forms).
Contact Us & Pay My Bill
To learn more about the EPI Test, please call or email us.
Mon-Fri: 9:00am – 5:00pm EST
844-EXOSOME (844-396-7663) | Info.exosomedx@bio-techne.com
Pay My Bill Online *Available for patient invoices after 7/01/2020*