Eligibility is determined according to the U.S. government’s federal poverty guidelines, which are based on income and family size. These guidelines are updated each year.
To qualify for FREE services (100% financial assistance) your household income must be at or below 200% of the current federal poverty guidelines. See chart below.
To qualify for partial financial assistance, your household income must be between 200% to 350% of the federal poverty guidelines for hospitals. See chart below.
The matrix below is to be utilized for determining the level of assistance for patients who are uninsured.
1. Patients who are uninsured and at or below the 200% FPG guideline will receive a full write-off of charges.
2. For uninsured patients who exceed the 200% FPG guideline, but have income less than the 350% FPG guideline, a sliding scale will be used to determine the percent reduction of charges that will apply. The matrix for the discount provided is noted below.
3. Patients who are insured and at or below the 200% FPG guideline must first satisfy an uninsured prompt pay visit fee of $85 regardless of income or ability to pay for all medically necessary services.