HCMA Genetic Testing Assistance Application

The HCMA knows that it is important to know who in your family is a genetic carrier for HCM and the peace of mind that can come from being prepared. We are happy to launch this new program to help families access genetic testing. Please download the application from the attachment section located to your right. Should you have any questions please call the HCMA at 973-983-7429.

The application attached to the right must be completed and submitted to the HCMA for processing within 7 days of recieving your authorization from your insurance carrier.  All applications must be signed by both the applicant and spouse/parent person test is being preformed on. Applications can be emailed back to HCMA at support@4hcm.org or faxed to 973-983-7870

The applications states the following:

This application will be reviewed by HCMA staff.  Information contained in this application is viewed as confidential. You are under no obligation to complete this application.  If you choose to complete the application and are awarded a grant, funds will be paid directly to the testing laboratory you have indicated and NO funds will be paid directly to an individual/family.  Grants are scored and  awarded based on predefined criteria.  Grants range from 10% to 90% of out of pocket liability. In the event the pre-authorized amount is not honored by the insurance carrier; additional liability amounts can re-apply for additional grants, if paid at a great rate HCMA will process a refund from the laboratory.  Applicants will be informed within 30 days of application as to the status of the request.  Eligibility requirements: Due to provisions in the gift to the HCMA that permits us to offer this program you must fulfill the following requirements to be eligible for this grant.  You may not be insured by Medicare or Medicaid.  You must have private insurance coverage and/or be a resident of the USA. Uninsured parties are eligible to apply. Testing must be completed after the start date of this program (9/14/09). This program is provided by an anonymous donation and will continue until funding is depleted.  Applications are taken on a first come first serve basis beginning September 14, 2009.