FAP Plain Language Summary 

Help for Patients to Pay Hospital Care Costs

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If you cannot pay for all or part of your care from our hospital, you may be able to get free or lower cost services.

Please Note

  1. We treat all patients needing emergency care, no matter what they are able to pay.
  2. Services provided by physicians or other providers may not be covered by the hospital Financial Assistance Policy. You can call 301-609-4400 if you have questions.

How the Process Works

When you become a patient, we ask if you have any health insurance. We will not charge you more for hospital services than we charge people with health insurance. The hospital will:

  1. Give you information about our financial assistance policy, or
  2. Offer you help with a counselor who will help you with the application.

How We Review Your Application

The hospital will look at your ability to pay for care. We look at your income and family size. You may receive free or lower costs of care if:

  1. Your income or your family's total income is low for the area where you live, or
  2. Your income falls below the federal poverty level if you had to pay for the full cost of your hospital care, minus any health insurance payments.

Please Note: If you are able to get financial help, we will tell you how much you can get. If you are not able to get financial help, we will tell you why not.

How to Apply for Financial Help

Hospital care is available to all patients regardless of their race, color, national origin, age, gender, or ability to pay. Patients with balances due resulting from limited or no insurance coverage may qualify for our Financial Assistance Program. This program is designed to assist patients who are financially in need of help. UM Charles Regional Medical Center uses poverty guidelines issued by the U.S. Department of Health and Human Services to determine a person's eligibility. We may consider other financial assets and liabilities of the patient and family when determining the ability to pay.

The patient is responsible for providing information requested during the qualification process. Bills will continue to arrive until eligibility has been determined.

For additional information on UM Charles Regional's Financial Assistance Program or to receive a copy of the application, please call 301-609-4400 between 8:30 am and 4:00 pm, Monday through Friday.

  1. Fill out a Financial Assistance Application Form.
  2. Give us all of your information to help us understand your financial situation.
  3. Turn the Application Form into us.

PLEASE NOTE: The hospital must screen patients for Medicaid before giving financial help.

Other Helpful Information

  1. You can get a free copy of our Financial Assistance Policy and Application Form:
    • Online
    • In person at the Call Center at 5 Garrett Avenue, La Plata, MD 20646
    • By mail: call 301-609-4400 to request a copy
  2. You can call the Financial Assistance Office if you have questions or need help applying. You can also call if you need help in another language. Call 301-609-4400