Request for Financial Assistance Application
Important information on applying for financial assistance.
FINANCIAL ASSISTANCE
Who Can Apply
We consider each family’s financial situation independently. Please be sure to provide us any extenuating circumstances that are creating a financial hardship.
If you have further questions reach out to us at (406) 862-8146.
Child requiring travel is 18 years old or younger.
Family resides in Montana.
Child custody is parent(s) or the legal guardian(s).
Treatment is occurring outside of the child's community. Minimum distance from the child's / family's community is 100 miles.
Treatment must be prescribed by a licensed physician. Verification from the child's medical doctor may be requested.
Family has limited financial resources to cover medical travel expenses.
Fill out the online application
Please be sure to provide us a good contact email and phone number.
Application review
Once your application is received, we will contact you within 3 business days to review.
Committee review
Your application will be reviewed by a committee. All identifying information will be removed prior to committee review in order to protect your privacy. Please allow us up to 2 weeks to provide a determination.
Apply
Application Instructions
Doug Betters For the Children, Inc. provides financial assistance on a reimbursement basis. We require complete receipts for your travel expenses in order to be compensated. Financial assistance will be estimated using rates determined by Doug Betters For the Children, Inc. Dates on these receipts must match the dates of treatment. An advance check for a percentage of estimate may be available if needed prior to travel.
**Please read our policy form for complete information before applying.**
PROCESS
If Your Application Is Approved
- A Travel Reimbursement Form will be mailed to you. After your travel, fill out the form and attach all receipts. Be sure to sign the form. Your signature is verification that travel occurred for medical treatment reasons and that you did not receive other funding for these expenses.
- Once completed, mail the form and receipts in the self-addressed envelope included with your travel reimbursement form. You should receive reimbursement within 30 days of our receiving your form and receipts.
Have questions? Please call us at (406) 862-8146 or contact us using the form at the bottom of this page. We are here to help!
FAQ
Frequently Asked Questions
Will Doug Betters For the Children assist with medical expenses?
No. We only assist with travel expenses associated with reaching pediatric medical treatment. These expenses are the costs of lodging, transportation and meals.
Why do I need to provide receipts?
Doug Betters For the Children, Inc. is a 501(3)(c) nonprofit organization. We must comply with federal and state regulations to maintain our good standing. Complete, detailed receipts verify that monies given to families were used as intended for the purpose of our mission.
How far is outside the community?
Our guideline is that travel to the medical site must be at least 100 miles outside of your community. However, we do consider shorter mileage based on circumstances.
What are your income eligibility requirements?
Doug Betters For the Children, Inc. has no set guidelines. We consider each family’s financial circumstances to determine eligibility. You will be asked to provide your annual family income and number of members in the household as a basis.
My child has insurance, can I still get help?
Yes. We help Montana children with insurance whether private, Medicaid or HMK. However, we will ask if your insurance offers any travel reimbursement. If your insurance does offer help with travel expenses, our financial assistance will supplement what your insurance offers.
What does “reimbursement basis” mean?
Doug Betters For the Children provides financial assistance on a reimbursement basis. This means that you pay for the travel expenses and we will provide the monies after your travel as reimbursement. We understand that this may be a hardship for many families, so we do offer an option to receive a 50% advance check prior to travel if needed.
Can I apply multiple times?
Yes.
How long will it take to receive my reimbursement check?
Please expect 30 days for your reimbursement to be processed and mailed to you.
For The Children, inc.
Policy Form
Doug Betters For the Children, Inc. is a nonprofit organization. All funding comes from donations. We strive to make sure our donations are utilized appropriately. In addition, we must comply with IRS guidelines. Therefore, we greatly appreciate your understanding our requirements.
DISCLAIMERS:
- For the Children, Inc. does not pay for medical expenses.
- If your child has Medicaid or HMK, we compensate for those expenses beyond what they will reimburse. Please do not request reimbursement for expenses covered under Medicaid/HMK.
- For the Children, Inc. has the right to refuse financial assistance at any time.
TRAVEL EXPENSE POLICIES:
- Transportation is based on round-trip mileage to treatment city regardless of form of travel.
- Lodging is based on per diem. Please note that For the Children, Inc. uses a set rate to estimate lodging expense. If actual hotel rate is more, the responsibility of the remainder is to be paid by applicant. If actual rate is lower than estimated rate, For the Children, Inc. will only pay actual rate.
- Meals are based on a per diem rate. We provide financial assistance only for one adult and the child who is in need of medical care. Any child age 12 and under will receive half the adult per diem rate.
- Please note that the following items will not be reimbursed:
- Alcohol or Tobacco products.
- Junk Food – potato chips (including Doritos, Cheetos, etc.), candy, chocolate, liters of soda, high energy drinks, etc.
- Incidentals including but not limited to toiletries, diapers, toys, etc.
If you are approved, you must provide us receipts for your travel expenses in order to be compensated. The dates on these receipts must match the dates of your child’s treatment.
Contact Info
Contact Us
Have questions? Please call (406) 862-8146 or send us an email at info@dougbettersforthechildren.org.
