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Direct Assistance Programs

   
   Online Request Form

   Printable Request Form

 

Direct Assistance Recipients

In 2006, 250 people received $38,000 for prescription, dental and medical assistance.

Direct Assistance Guidelines for Healthcare Providers

Direct Assistance funding is provided by AVMF for people with needs for dental procedures, prescriptions, or emergency medical services. Requests to AVMF must not come directly from the patient needing help. Only a non-profit organization, governmental agency or healthcare provider may submit requests on behalf of the individual in need. Once approved, payments by AVMF are made to the healthcare provider or approved pharmacy. Individuals never receive financial assistance directly from AVMF.

Policy and Proceedures

  • AVMF must be notified by FAX before any funds are committed for patients. You may use the Online Request Form or print and fill out the Printable Request Form. Please make copies and FAX form to AVMF before funds committed.
  • Do not have patients contact AVMF under any circumstances.
  • When in doubt, contact AVMF by phone at 544-1298.

Prescription Assistance

  • A maximum of $150 per person per year will be provided.
  • Pre-approval is required.
  • Provider notes AVMF Pharmacy Fund on prescription.
  • Pharmacy bills AVMF for payment.

Dental Assistance

  • A maximum of $150 per person per year is available for emergency care only.
  • Pre-approval is required.
  • No other dental procedures will be considered other than basic emergency procedures to reduce pain or suffering of patient.
  • Dentist bills AVMF for payment.

Medical Assistance

  • Funds available for extraordinary medical needs.
  • Prior approval is required

 970.544.1298  •     • PO Box 1639  • Aspen, Colorado 81612
©2007 ASPEN VALLEY MEDICAL FOUNDATION