Patient Assistance Program

 
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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 apply, patients must live in the United States or a US territory, have insufficient insurance coverage to pay for the test, meet certain income eligibility guidelines (the table below outlines the income eligibility guidelines to qualify for the PAP) and complete a PAP application.

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. A minimum of $50 is required to enroll in the payment plan, which will be applied to the account balance. Missing a payment without making prior arrangements may jeopardize enrollment in the PAP.

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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
1 $12,490 $24,980 $37,470 $48,960
2 $16,910 $33,820 $50,730 $67,640
3 $21,330 $42,660 $63,990 $85,320
4 $25,750 $51,500 $77,250 $103,000
Out of
pocket costs
$100 $175 $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

*The 2019 Poverty Guidelines are in effect as of January 11, 2019. ExosomeDx follows the poverty guidelines as set by the U.S. Department of Health and Human Services. The current guidelines can be found at aspe.hhs.gov/poverty-guidelines. Income levels are subject to change at any given time.

 

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

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