Medical Reimbursement Assistance Applications
Maximum amount an individual with Spina Bifida can request in a calendar year is $300
To the Applicant: SBJ has established a Medical Reimbursement Assistance Fund to be dispersed to families living with spina bifida that need assistance with uninsured medical expenses (co‐pays, medical supplies, adaptive equipment, and therapy directly related to caring for an individual with Spina Bifida.) Requests need to be submitted in writing. Financial assistance is limited and is offered on a first come, first served basis. If aid for the calendar year has been exhausted, no further aid will be granted until the next calendar year. This fund is established from dollars set aside for medical reimbursements.
- Applicant must have Spina Bifida or be a parent/caregiver of a child with Spina Bifida.
- Applicant must reside in North Florida or South Georgia.
- Application and required documentation must be received in its entirety.
- Fill out application completely.
- Please provide a copy of the receipts for the uninsured expenses being reimbursed or the uninsured invoice (or a valid prescription).
- All expenses must be submitted in the year in which the expense incurred. Expenses occurring in December will be reviewed in January of the following year.
- Applications will be reviewed on a monthly basis.
- The application will be presented to the SBJ Reimbursement Review Committee for review.
- SBJ staff or board members may contact you if additional information is needed.
- Designated SBJ staff will contact the family or individual upon approval or disapproval of the request. If approved, SBJ will discuss disbursement arrangements with the applicant.
This application does not cover requests for community awareness scholarships, camp/recreation program/special event, primary and secondary education support, and automobile modifications.
SBJ reserves the right to revise this policy annually in accordance with its changing financial position.
For more questions, call Demery Webber at 904.699.6640 or email Demery.firstname.lastname@example.org