Quality of Life Reimbursement Grants

People with ALS who are registered with us may qualify for our Quality of Life Reimbursement Grants. These financial grants provide up to $1,200 per patient per year to support disease-related expenses.

Eligibility

  • Must have a diagnosis of ALS or PLS.
  • Applicant must be registered with ALS United Ohio.
  • Grant must be used to offset the financial burden of living with ALS or PLS.

Eligibility exclusions: Veterans with ALS who are receiving service-connected VA benefits.

Grant Details

  • Grant is limited to a total of $1,200 per applicant for approved incurred expenses.
  • Grant requests must be related to the diagnosis of ALS or PLS, such as equipment, care and/or services. Please refer to the Grant Guidelines for covered benefits. Some benefits may require a prescription from a medical professional.
  • An applicant may be asked to provide verification of diagnosis of ALS or PLS through a “Verification of Diagnosis” Form which must be completed by a neurologist who specializes in ALS or PLS.
  • Grants will be paid as an expense reimbursement. Patients must first incur the expense then be reimbursed via the grant program. Copies of receipts or invoices CLEARLY indicating payment(s) are necessary.
  • Grants will be disbursed to patients according to date received until the limits of the grant funding budget is reached.

If you believe you qualify for our Quality of Life Reimbursement Grant, please download the documents that comprise the Grant Packet below. If you prefer a hard copy of the Grant Packet mailed to you, please contact your care services coordinator.

 

Grant Guidelines

Reimbursement Request Form

Store Receipt Log

Services Receipt Log

Mileage Log