Patient Financial Assistance FAQ

We know most medical costs are unexpected and understanding the financial assistance process can be complicated. Our financial counselors are here to help. If you have a question that is not answered below, feel free to call 319-339-3905. 

What is financial assistance?

We are committed to providing all of our patients with high-quality care and services. As part of this commitment, the hospital and clinics work with individuals with limited incomes and resources to find available options to cover the cost of their care.

Financial Counselors will help uninsured and underinsured individuals apply for health coverage through a public assistance program or the hospital’s financial assistance program, and work with individuals to enroll as appropriate. Assistance for these programs is determined by reviewing, among other items, an individual’s household income, assets, family size, expenses and medical needs.

If you think you might qualify for assistance, we encourage you to contact us and apply.

Who qualifies for financial assistance?

Financial assistance is available for patients with limited incomes and who are uninsured or under insured.

Patients may be eligible to receive financial assistance for non-emergency, medically necessary services if they meet the income limits.

If approved, financial assistance reduces your bill. How much it is reduced is based on established guidelines that include: income level, existing debts, medical situation and other indicators of inability to pay.

If your income is at or below 200 percent of the current Federal Poverty Guidelines and you meet program guidelines, you may be eligible for care at a reduced cost or no cost to you.

How can I see if I meet program guidelines?

Beginning 1-13-2021, the patient is eligible for the following discount if he/she submits a complete financial assistance application.


What if I do not meet income limits for financial assistance?

If you cannot pay your bill, payment plans may be arranged. Please contact us at 319-339-3905 to speak with a Financial Counselor.

What do I need to apply for financial assistance?  

­­

Examples of acceptable documentation

Confirmation of Annual Income

  • Last two  pay stubs
  • Recent Federal Income Tax Return
  • Most recent W-2 or 1099
  • Social Security Award Letter
  • Workers Compensation Award Letter
  • Pension or Annuity Statement

Identity Proofing Verification

One of the following:

  • Driver's license
  • School identification card
  • Voter registration card
  • U.S. military card or draft record
  • U.S. passport or U.S. passport card
  • Illinois ID
  • Military dependent's identification card
  • Native American Tribal document
  • U.S. Coast Guard Merchant Mariner card

Permanent resident card or alien registration receipt card (Form I-551)

Employment Authorization document that contains a photograph (Form I-766)

Foreign passport or identification card issues by a foreign embassy or consulate that contains a photograph

OR any two of the following:

  • Birth certificate
  • Social security card
  • Marriage certificate
  • Divorce decree
  • Employer identification card
  • High school diploma or college diploma
  • Proper deed or title

Verification of residency

  • Utility bill
  • Rental agreement/lease
  • Mortgage statement
  • Tax bill
  • Rooms & board statement
  • Written verification from landlord  

What is the average out-of-pocket cost for someone without insurance? Costs will vary depending on the health care service rendered and the setting in which the care is delivered. You may call us at 319-339-3905 for an estimate.

Can someone explain the financial assistance program and help me apply? Yes, free confidential help is available..

Yes, free confidential help is available. Call our Financial Counselors at 319-339-3905, or visit the financial counselors at 500 E. Market Street, Iowa City, Iowa

The Financial Counselor can tell you if you qualify for free or low-cost insurance such as Medicaid. The Financial Counselor will help you complete all the forms and tell you which documents you need to bring.