Our Financial Assistance Program provides a discount on bills for medically necessary care. The program may cover current and outstanding bills - up to 36 months prior to the enrollment in the program - and may remain in effect for 6 months after enrollment.
You may qualify for financial assistance when:
You are uninsured.
Your insurance policy does not provide full coverage for medically necessary (PDF) care.
You have substantial out-of-pocket expenses and are unable to manage your medical bills.
To determine if you would be eligible for one of our Financial Assistance Programs, you will need to complete a Financial Assistance Application (PDF)and provide all the necessary documentation that is required.
You may be eligible for a 100% discount if your household income is below 160% of the Federal Poverty Income guidelines.
You may be eligible for a 75% discount if your household income is less than 225% of the Federal Poverty Income guidelines.
You may be eligible for a 50% discount if your household income is less than 310% of the Federal Poverty Income guidelines.
If your income is above 310% of the Federal Poverty Income guidelines and your medical bills exceed 20% of your annualized income, you may also apply for a catastrophic discount. This program is limited to one episode of care which includes any subsequent medical treatment or services related to that same episode of care, or a series of ongoing medical service that are intended to treat a specific diagnosis. A Financial Assistance Application will need to be completed to be considered for this discount.
You can contact us for more information regarding the Financial Assistance Program. Once we have reviewed a completed application, which includes the necessary documentation; within 30 days of receiving the completed application, our office will notify you of the determination by letter. Failure to provide a completed application will result in a denial.
Learn more and apply with the links below:
-Financial Assistance Brochure (PDF)
-Financial Assistance Policy (PDF) Hospital or Clinics
-Financial Assistance Application (PDF) Hospital or Clinics
-Financial Assistance Policy Clinic Policy (PDF)
-Financial Assistance Application Clinic Application (PDF)
-Providers not covered Services & Providers Not Covered (PDF)