Charity Discount Policy


    Pricing Estimates and Information - Uninsured Patients


    Charity Discount Policy

    Financial relief may be available to patients who received non-elective care, who do not qualify for state or federal assistance, and who are unable to establish partial payments or pay their balance. In most cases, patients that fall between 0 percent and 200 percent of the federal poverty level. The federal poverty levels based on total household income, with sufficient supporting documentation provided by the patient, will have a 100-percent charity discount processed.

    For patients with balances greater than $1,500, and whose documented income is between 201 percent and 400 percent of the federal poverty level, we have an expanded charity policy that may reduce the amount you owe. To determine if non-elective services you received could be eligible for either full charity or partial charity, please contact your hospital for details.

    The following classes of patients may qualify for a charity discount:

    • Under insured patients (i.e., those patients with some form of third-party payer coverage for healthcare services but such coverage is insufficient to pay the current bill) when indigency is established, and the out-of-pocket responsibility is $1,000 or higher.
    • Uninsured patients (i.e., those patients with no third-party payer coverage for healthcare services whatsoever), who are unable to pay their account balances.

    Some locations may have identified additional criteria for charity eligibility besides the federal poverty levels as noted above (i.e., high medical costs, more lenient income levels, etc.). To verify your eligibility for assistance under this policy, we recommend you contact the hospital.

    A validation must be completed by the hospital to ensure that if any portion of the patient's medical services can be paid by any federal or state governmental health care program (e.g., Medicare, Medicaid, Champus, Medicare secondary payor), private insurance company, or other private, non-governmental third-party payor, that the payment has been received and posted to the account. No charity discount can be applied to any account with any outstanding payer liability.

    Pricing Estimates and Information - Uninsured Patients

    All Medicare accounts and all non-Medicare inpatient accounts will be required to have supporting income verification documentation. Medicare requires independent income and resource verification for a charity care determination with respect to Medicare beneficiaries (PRM-I ยง 312).

    Income Verification

    For Medicare beneficiaries, in addition to thorough completion of the financial assistance application, the preferred income documentation will be the most current year's federal tax return. Any patient/responsible party unable to provide his/her most recent federal tax return may provide two pieces of supporting documentation from the following list to meet this income verification requirement:

    • State income tax return for the most current year
    • Most recent pay stub
    • Written documentation from income sources
    • Copy of all bank statements for the last three months
    • Current credit report

    For non-Medicare and outpatient accounts, supporting income verification documentation may NOT be required. For these accounts, the thorough completion of the financial assistance application may be acceptable for determining charity discount application.

  • Memorial Health University Medical Center makes no guarantees regarding the accuracy of the pricing information provided herein. The pricing information provided by this website is strictly an estimate of prices, and Memorial Health University Medical Center cannot guarantee the accuracy of any estimates. All estimates are based on information provided by a prospective patient and do not include, among other things, any unforeseen complications, additional tests or procedures, and non-hospital related charges, any of which may increase the ultimate cost of the services provided. Any prospective patient should understand that a final bill for services rendered at Memorial Health University Medical Center may differ substantially from the information provided by this website, and Memorial Health University Medical Center shall not be liable for any inaccuracies.