Apply for Help

Financial Assistance for Breast Reconstruction
We're here to help. For two decades, My Hope Chest has been the only national organization helping make you whole again in body, mind and spirt through breast reconstruction surgery. When you qualify for financial assistance for breast cancer reconstruction, we will hold your hand every step of the way to provide the final step in breast cancer treatment, full closure and new beginnings.

I’D LIKE TO APPLY FOR

BREAST RECONSTRUCTION SURGERY
INSURANCE CO-PAY ASSISTANCE
NON-MEDICAL BILL PAY ASSISTANCE

My Hope Chest is continually works on raising money to help more and more women on our waitlist. We currently have limited funding for financial assistance for breast cancer reconstruction. We select applicants who qualify, on a first come first serve basis. Please be clear about your request in dollars, in your application story.

Applicant Wait List

How to Apply to Become a Butterfly!

  1. Make sure you're eligible
  2. Submit the Online Application Form
  3. Submit the Client Agreement Form
  4. Submit the Client Media Release Form
  5. Take the Breast Reconstruction Survey

Next Steps /Proof of income. You will be required to submit 3 months of bank statements and 2 years of tax returns.  If your matter is urgent, please be gathering these documents. *Black out account numbers before sending personal financial information.

Are you eligible?

You must be 65 years of age or younger, free of medical complications that would preclude safe surgery (as determined by our participating surgeons and medical consultants), able to show demonstrable need* and a legal resident or citizen of the United States to qualify for financial assistance for breast cancer reconstruction.

*Demonstrable need shall include consideration of the following criteria:

  1. Uninsured or Underinsured
  2. Have applied for government insurance through the Marketplace. Proof of acceptance or denial is required.
  3. Proof of non-eligibility for Medicaid (annually)
  4. Income that does not support self-funding of care
  5. Hardships or exceptional circumstances.

Frequently Asked Questions

What if I'm unable to file the application online?

Download and print a PDF of the Client Application and Client Agreement Form in English or Spanish or request an application by mail.

Please return your completed application to:

My Hope Chest
4579 East Spruce Drive
Dunnellon, FL 34434

Please direct your questions to Client Navigator @ (727) 488-0320 from or email navigator@myhopechest.org

How soon can I receive help?

While My Hope Chest can not guarantee if or when we can help applicants, it is our goal to serve as many survivors as possible as quickly as possible each year.  Because we receive referrals from the largest breast cancer charities in America that do not fund reconstruction surgeries, we have an ongoing wait list nationally so we appreciate your patience and advocacy.

What can I do while I wait?

We understand waiting is hard, to be proactive in the meantime, do this:

For Surgery Assistance

Download our Breast Reconstruction Education and Options pamphlet to learn about your reconstruction options. Ask your plastic surgeon if you can work out a payment plan.

For Bill Pay Assistance

Start with your oncology group and ask if they have a “foundation.”  These foundations often have funds to help pay patient bills during treatment. Contact your local hospitals, especially a university hospital. Speak to the “breast care centers'' that have experience and resources to assist breast caner patients. within these hospitals may also have resources about foundation funds that may be available.  Oftentimes these larger institutions have resources and funds set aside for “uninsured” individuals.

For Medicine Assistance

If you need help with medicine, again speak with your oncologist (let them work for you.) Ask them for the manufacturer of the drugs and number for you to reach out directly to the pharmaceutical companies that often have programs to assist with medicines.

help us help you

Advocate for My Hope Chest. Share our vital mission with your surgeon and doctors and in your community. Follow us and share the charity's work on social media and with friends and family. Paying it forward may be the quickest way we can help. Contact us to learn more.

Pay It Forward!

You can help raise awareness of your problem by sharing My Hope Chest’s information in your community, with your newspapers and local groups

I Want to Help 💛