Lyme-TAP Application

The Lyme Test Access Program (Lyme-TAP) is a nationwide (USA) assistance program for initial Lyme-related lab tests for eligible patients facing true financial hardship based on household income and insurance status. The program is not designed to assist residents of other countries.

Lyme-TAP program funds are temporarily depleted. We are currently not accepting applications. Please check the website regularly for reopening when funds are available again.

Download the application by clicking on the button below and fill out the form completely. This is an interactive form and you can type directly into the fields supplied. Once you are finished, simply print out the form, sign it, and have your doctor sign it.

Submit the following to the submission fax line 707-924-3013, or email in PDF format to info@lymetap.com  (no cell phone photos, please!):

  • Your completed application form. Please fill out the form by typing directly into the fields. If you are filling out the form by hand, please print clearly. (Submit separate application forms for additional family members.) Our staff communicates primarily via email. Failure to provide an email address may delay processing of your application.
  • Pages 1 and 2 and Schedule 1 of your 2018 1040 Federal tax return, or page 1 of 2017 1040. Please see Lyme-TAP Tips if you do not file a tax return.
  • Your laboratory test receipt(s) for lyme-related tests only. Lyme-TAP does not offer grants for testing for viruses, other general lab tests, or doctor fees. Please do not send test results.
  • If opting for a prepayment to the lab, submit a copy of your lab requisition form with pricing, completed and signed by your healthcare provider. Prepayments may not be possible with all laboratories. It is recommended that you do your blood draw AFTER receiving your grant from Lyme-TAP. Prepayment checks will be made payable to the laboratory. Prepayments may take longer to process than reimbursements and may not be possible with all laboratories.
    • Please Note: Prepayments are not available for labs that do not have readily available published price lists. For labs that offer financial assistance programs, please submit the lab’s response to your request for assistance.
  • Payments of grant funds may take several weeks for processing – we are not responsible for delays.

If you have faxed this information, please follow up with an email to the program administrator [info@lymetap.com] indicating that you have sent in your fax.

Applications may also be submitted by mail to the address shown below. Please note that mailed applications may take longer to process. You may also email a PDF scan of your documents (NOT cell phone photos) to info@lymetap.com.

Lyme Test Access Program (Lyme-TAP)

P.O. Box 2238, McKinleyville, CA 95519

If approved, you may be reimbursed for up to 75% of the list price that the labs publish for testing costs for lyme, co-infections and CD57 from a qualified, CLIA/Medicare-approved lab of your choice. 3rd-party charges for lab tests may vary from the actual list price charged by the labs. Funds are limited & are available on a first-come, first-served basis. Children under 18 years of age are given priority. The intention of this program is to help as many patients in need as possible. It is not intended to cover patients not truly in financial need or insurance deductibles.

Please refer to Lyme-TAP Tips for any questions that you may have regarding the application process.