PATIENT FINANCIALASSISTANCE INSTRUCTIONS PATIENT FINANCIAL ASSISTANCE REQUEST FORM

MCCA has a program to help provide limited financial assistance for cancer patients who live in Montgomery County, Illinois.

Beginning January 1, 2026…. after completing requirements, each patient is allotted $4,000 for expenses such as rent, mortgage, utility bills, medical bills, etc., PLUS mileage to/from medical appointments.

Requirements:

• Minimum 1-year permanent residence in Montgomery County, Illinois

• Written order by attending physician as proof of cancer diagnosis

• Completed MCCA application

Contact Daniel Britton at (217) 710-0301 for an application; or any board member for more information

*****NEW IN 2026*****

Forms are now available online!

Please click on the links below to download the Instructions and Financial Assistance Request Form.