CLICK HERE TO DOWNLOAD THE LIFELINE APPLICATION.
CLICK HERE TO DOWNLOAD THE LIFELINE SUBSEQUENT APPLICATION*.
CLICK HERE TO DOWNLOAD THE LIFELINE PROGRAM GUIDELINES.

Treating and managing a bleeding disorder is often an extremely costly endeavor. The Lifeline Program is a fund through which individuals with bleeding disorders can receive financial help with high insurance premiums, COBRA payments, catastrophic out-of-pockets, and medical expenses associated with the diagnosis and treatment of bleeding disorders. The program is administered by the Utah Hemophilia Foundation.

Financial assistance through the Lifeline Program is available to many within Utah's bleeding disorders community. If you feel that you are eligible to participate, we encourage you to complete and submit an application. Applications are available online or by request to the staff of the Utah Hemophilia Foundation by phone (801) 484-0325 or by email at info@hemophiliautah.org. For more information, please read the Lifeline Program Guidelines. A DVD multimedia presentation about the Lifeline Program is also available upon request. Please call or email the staff with any questions you may have about the Lifeline Program.

Eligibility Requirements

• Residency in Utah for the past 12 months or longer
• Verification of the diagnosis of a bleeding disorder
• Verification that annual out-of-pocket insurance and medical expenses for all household members are greater than 7.5% of an applicant's adjusted gross income

Application Procedure

• An application is completed and submitted to the Utah Hemophilia Foundation.
• Required documentation is submitted with an application. This must include an applicant's latest tax return, paycheck stubs, and proof of payment of insurance and medical expenses directly related to treatment of a bleeding disorder.
• The complete application/documentation is reviewed by a committee for timely determination of eligibility.

A Personal Perspective

"About seven months ago our son Cade was diagnosed with severe hemophilia. We have no family history at all, so it came as quite a shock to us. When we met with the team of doctors and nurses to discuss the treatment that he would need throughout his life and the cost of that treatment, we were quite overwhelmed. Not only was this new diagnosis completely life-altering, but we didn't know how we would be able to afford the treatment he needed to stay healthy and active.

"When we got in contact with the Utah Hemophilia Foundation, they were really good to help us through the process of applying for the Lifeline grant. It was really easy, and they helped us to get all the paperwork and necessary things so that we could apply and qualify for the money.

"The Lifeline grant has enabled us to learn and be able to free up our time and resources, to not be worried about money all the time, to be learning about what we can do to better help our son so he can grow up and live a life largely unaffected by what he's been diagnosed with. We're terribly grateful for it and can't say enough to say thank you for it."

--Tyler and Jennifer Mertlich

CLICK HERE TO DOWNLOAD THE LIFELINE APPLICATION.
CLICK HERE TO DOWNLOAD THE LIFELINE SUBSEQUENT APPLICATION*.
CLICK HERE TO DOWNLOAD THE LIFELINE PROGRAM GUIDELINES.

*The long Lifeline Application only needs to be completed once a year. If you have further expenses within that year that you would like us to consider, please complete and submit the Subsequent Application.