Enabling this provides you with more accurate distances to providers and locations
Get the care you need no matter what.
Whether you have insurance or not, you have multiple options when it comes to affording your care. We'll help find the one that's right for you.
Financial assistance options include federal, state and local aid as well as a variety of charitable programs. We may also be able to reduce or eliminate your financial responsibility for medically necessary and appropriate treatment if you qualify under financial hardship guidelines. This is based on a percentage of established Federal Poverty Income Guidelines, household income and assets. We also have payment plan options which you can explore here.
Simply complete the forms listed below and reach out to us if there's anything we can do to help make the process easier.
Use this form to apply for financial assistance:
Confidential Financial Assistance Application - English
Confidential Financial Assistance Application - Albanian
Confidential Financial Assistance Application - Arabic
Confidential Financial Assistance Application - Bengali
Confidential Financial Assistance Application - Bosnian
Confidential Financial Assistance Application - Karen
Confidential Financial Assistance Application - Kinyarwanda
Confidential Financial Assistance Application - Korean
Confidential Financial Assistance Application- Nepali
Confidential Financial Assistance Application- Spanish
Use this form to check eligibility and where to submit your application:
For a list of providers that do not participate with our financial assistance policy, click here.
Use this form to check eligibility and where to submit your application:
Financial Assistance Eligibility Policy Summary - English
Financial Assistance Eligibility Policy Summary - Albanian
Financial Assistance Eligibility Policy Summary - Arabic
Financial Assistance Eligibility Policy Summary - Bengali
Financial Assistance Eligibility Policy Summary - Bosnian
Financial Assistance Eligibility Policy Summary - Karen
Financial Assistance Eligibility Policy Summary - Kinyarwanda
Financial Assistance Eligibility Policy Summary - Korean
Financial Assistance Eligibility Policy Summary - Nepali
Financial Assistance Eligibility Policy Summary - Spanish
Financial Assistance Eligibility Policy Summary - Swahili
Financial Assistance Eligibility Policy Summary - Vietnamese
Use this form to reference the maximum amount billed to those eligible for financial assistance:
If you have any questions or need help applying, we're here for you.