Eligibility Requirements

Eligibility requirements are set for those who request Community Care. The HSHS Financial Assistance Program is not a substitute for personal responsibility. We look at income and cash assets, along with family size. Current financial changes also are taken into consideration. Applications for Community Care will be accepted from any patient without regard to the individual’s sex, race, color, religion, sexual orientation, national origin, age, disability or marital status. Guidelines are updated annually. 

This policy does not offer a provision for assistance to patients with sufficient means who refuse to pay for the medical services rendered to them or to their family members. The Financial Assistance Program is intended to help patients resolve their HSHS medical balances after exhausting all other financial options.

We will make every effort to secure financial assistance to those who qualify. We will make available upon request an application for Community Care (charity) to any patient or responsible party. If you intend to apply for Community Care you will be required, at a minimum to furnish a copy of your most recent federal tax return to assist in identifying potential need. Contact Patient Financial Services at 920-433-8122 or 800-211-2209 for more information.