Charity Care and Financial Assistance

Charity Care and Financial Assistance

PinnacleHealth provides charity care (free care) and financial help for people who can’t pay for the healthcare services they need. PinnacleHealth treats people who can’t pay their bills with the same respect and dignity that it shows to all of its patients.

Charity Care

Charity Care means the ability to receive free care. Patients can receive charity care if they meet all of the following three criteria:

  • Don’t have insurance coverage for a medically necessary service
  • Are ineligible for governmental or other insurance coverage
  • Have a family income below 250% of the Federal Poverty Level

Patients who are insured and have a family income in excess of 250% of the Federal Poverty Level will also be eligible for charity care for their financial responsibility.

Financial Assistance

Financial assistance means ability to receive care at a discounted rate. Patients who are uninsured for a medically necessary service will also receive financial help if they meet all of the following three criteria:

  • Don’t have insurance coverage for the medically necessary services
  • Are ineligible for governmental or other insurance coverage
  • Have family income in excess of 250% (but not exceeding 400%) of the Federal Poverty Level

Uninsured Patient

An uninsured person is an individual who does not have any third-party health care coverage through a third party insurer,  an ERISA plan, Federal Health Care Program (including Medicare, Medicaid, SCHIP and TRICARE), Workers' Compensation, Medical Savings Accounts or other coverage for all or any part of the bill. Patients who have exhausted their health insurance benefit coverage will be considered uninsured.

In addition to comparing the income amounts to the Federal Poverty Levels, total resources available will be reviewed. Charity Care or financial assistance may not be offered to those patients that have sufficient assets to pay and the liquidation of those assets would not cause undue hardship.

Charity Care and Discount Rates

% of Federal Poverty Levels     Discount Category        Discount %
0% - 250% Charity Care 100%
251% - 300% Financial Assistance 80%
301%-400% Financial Assistance 60%

Applying for Charity Care or Financial Assistance

Patients who want to apply for Charity Care or financial help should complete the Financial Aid Application. Patients will be asked to provide the minimum required documentation as noted below:

  • Pay stubs for past 2 months
  • Bank statements (checking & savings) for past 2 months
  • Copy of last filed Federal tax return including all schedules
  • Copy of notice received from Social Security Administration indicating monthly benefit
  • Copy of notice received from Bureau of Unemployment for weekly benefit
  • Copy of any pension payments that are received monthly
  • Notice of current Medical Assistance denial or approval (if applicable)
  • If household has no income, letters from persons who are assisting with daily living expenses

Completed Financial Aid Applications can be mailed to:

Financial Aid Representatives
PinnacleHealth Hospitals
P.O. Box 2353
Harrisburg, PA 17105-2353

Each application is reviewed by our staff members. They will make sure it is complete and decide if the patient qualifies for Charity Care or Financial Assistance.

All applicants, who apply for charity care and have provided all the necessary documentation, are notified of financial determination by phone or by letter within 30 days of receipt.

Note: Except in the case of those individuals within 250% of the Federal Poverty Levels, this policy does not apply to patients who are insured or underinsured: for example: it  is not the intent of this policy to provide free or discounted care to patients who have health insurance with deductibles or coinsurance.

 
With the individual insurance mandates that have taken effect as part of the Affordable Care Act and the expansion of the Medicaid program, refusal or unwillingness on the patient’s part to enroll in a subsidized insurance plan could impact the level of financial assistance provided through this policy.


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