EVERLASTING HOPE GRANT

** OUR EVERLASTING HOPE IS NOW OPEN! **
WE WILL BE ACCEPTING APPLICATIONS UNTIL AUGUST 3, 2020

To help alleviate the financial burden of infertility, Everlasting Hope provides financial assistance to couples battling infertility through the Everlasting Hope Grant.

  • The Grant awarded shall provide funds to cover the following treatment: initial physician consultation, monitoring labs, monitoring ultrasounds, nurse IVF education session, physician fees for egg retrieval and one embryo transfer (fresh or frozen), and lab fees for egg fertilization.
  • The Grant does not provide funds to cover other medical treatment/procedures/medications including, but not limited to, medications, any infertility diagnostic testing, such as a Hysterosalpingogram, any testing/procedure/treatment performed outside the facility of IRH, any treatment/surgery that may be medically needed to be a candidate for IVF such as Laparoscopy, any treatment/surgery/ costs of side effects or complications, hospital charges, Intracytoplasmic Sperm Injection (ICSI), assisted hatching, PGD/PGS biopsy, embryo cryopreservation and embryo storage fees, semen analysis, pregnancy blood work, ultrasounds coded as maternity, donor fees, donor prescreening or donor medications, or gestational carrier fees. This is a comprehensive list of exclusions at this time and there may be additional tests/programs that may be considered exclusions, as well as any other test, products or services not specifically listed herein as part of the Grant. Other restrictions may apply. Other uses of the Grant may be approved or excluded at the sole discretion of Everlasting Hope.

ELIGIBILITY

Participant must do the following and shall meet the following requirements to be eligible to participate and receive a Grant:

  • Must be at least 21 years of age, but younger than age 40 years of age as of April 6, 2020.
  • Must be a U.S. citizen or legal resident.
  • Must be have a weight of under 225 pounds.
  • Must have an infertility diagnosis that falls into one of the following categories:
      • Have a medical diagnosis of infertility by a Reproductive Endocrinologist according to the American Society for Reproductive Medicine’s definition of Infertility;
      • Be a carrier of a genetic disease or chromosomal disorder that requires the use of Assisted Reproductive Technology (“ART”) services for healthy offspring; or
      • A Reproductive Endocrinologist has recommended ART services due to recurrent pregnancy loss.
  • Participant cannot have a medical condition that is a contraindication to achieving pregnancy. Please consult your Reproductive Endocrinologist to determine if you have such medical condition.
  • Must have a combined (if applicable) gross income under $125,000.
  • May not have health insurance the covers the cost of infertility treatments.
  • Applicant must begin infertility treatment within 6 months of the date the Grant is awarded.
  • May not be a current or former member of the Board of Directors and Officers of Everlasting Hope, and immediate family members (Spouse, Child, Parent, Brother, Sister, Grandparent, Step-Parent, Step-Child, Step-Brother, Step-Sister and Niece or Nephew) of the current and former Board of Directors or Officer.

The above is a summary of the eligibility requirements.  For full details regarding eligibility, please review the Grant Application.

APPLICATION REQUIREMENTS

  • Completed Grant Application using the following documents:
    • Everlasting Hope Application
    • Physician Recommendation Form
    • Patient Authorization for Use and Disclosure of Protected Health Information Form
    • Media Release Form
    • Applicant Liability Release Form
  • Personal Story or Video
  • Photocopy of applicant’s health insurance card and that of a partner.
  • $25 non-refundable Application fee and is considered a donation which may be tax deductible. We only accept a cashier’s check payable to Everlasting Hope or use the online link below. All application fees help fund the Everlasting Hope Grant so we can continue to provide grants.

The above is a summary of the Application Checklist.  For full details, please review the Application Checklist in the Everlasting Hope Grant Application.

GRANT PROCESS

  • All Applicants (and Co-Applicants) are expected to fully complete, execute and provide the documents and other information set forth on the Everlasting Hope Grant Application Checklist. Applications WILL NOT be considered if not fully complete, so please take the time to review and complete the Application Checklist to ensure your Application is complete.
  • All Applicants will have eight weeks to complete the Grant Application and any additional documentation listed within the Application Checklist. Applications must be received by Everlasting Hope by the deadline date of June 1, 2020. No late submissions accepted.
  • After all Applications are received, the Board of Directors of Everlasting Hope will meet to review the Applications and determine which Applicant(s) will receive a Grant. The number of Grants awarded will vary from year to year. Everlasting Hope Grant amounts will be dependent on fundraising efforts and donations collected by Everlasting Hope. While we would love to offer grants to every applicant, please note not all applicants will receive grants. Even though we would like to, we cannot fund all those who apply.
  • The chosen Applicant(s) shall be notified of the Board of Directors’ decision by August 3, 2020. Applicants who are not chosen shall be notified of the Board of Directors decision after all chosen Applicants have accepted the Grants.
  • Please do not contact Everlasting Hope during the review process. A Member of the Board of Directors will notify you to confirm receipt of your Application and will contact you if more information is required.

APPLICATION

To download the application package, please use the link below.

PAYMENT

  • $25 non-refundable Application fee and is considered a donation which may be tax deductible. We only accept a cashier’s check payable to Everlasting Hope or use the online link below. All application fees help fund the Everlasting Hope Grant so we can continue to provide grants.

 

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