Financial Assistance

FAP Plain Language Summary

Language Translation Provided

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Help for Patients to Pay Hospital Care Cost

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. There may be services provided by physicians or other providers that are not covered by the hospital’s Financial Assistance Policy.  For a list of physicians providing emergency and other medically necessary care in the hospital facility, whose services are not covered under this policy, please visit our website or contact our Financial Assistance Department at (443) 843-5092.
  3. You will never be charged for emergency and other medically necessary care more than amounts generally billed to patients who are not eligible for financial assistance under the financial assistance policy. Rates are set by the State of Maryland.

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: The hospital must screen patients for Medicaid before giving financial help. Cosmetic and other non-medically necessary services may not be covered.

OTHER HELPFUL INFORMATION:

  1. You can get a free copy of our Financial Assistance Policy and Application Form:
         –By clicking the following links: Financial Assistance Policy and Application Form or using any of the other links provided on this page
         –In person at UM Upper Chesapeake Health, 2027 Pulaski Highway Ste 215, Havre de Grace MD 21078
         –By mail by calling (443) 843-5092 to request a copy.
  2. You can call the Financial Assistance Department at (443) 843-5062 if you have questions or need help applying
  3. The FAP, FAP application or Plain Language Summary are also available in Spanish. If you need information translated in another language, please call (443) 843-5062.

    Self Pay Billing Policy
    Poverty Guidelines