Financial Assistance at University Hospitals
- UH Financial Assistance Program Overview (PDF)
- Financial Assistance Application (PDF)
- Lake Health Financial Assistance Application (PDF)
- Laboratory Financial Assistance Application (PDF)
- Financial Assistance Policy (PDF)
- Hospital Credit and Collection Policy (PDF)
At University Hospitals, all individuals are treated with respect, regardless of their individual financial circumstances, and no one is denied or delayed emergency or medically necessary care because of his or her inability to pay for services.
If you meet established financial eligibility requirements, your bill for emergency medical or medically necessary care at a UH hospital facility may be discounted under the UH Financial Assistance Program.
Eligibility for Financial Assistance
You may be eligible for financial assistance if you are a resident of Northeast Ohio, have received care at one of UH’s participating hospital facilities and have one or more of the following criteria:
- Have no health insurance
- Are medically indigent as determined by medical expenses as a percentage of family income
- Have health insurance and an annual household income of 0 – 400 percent of the Federal Poverty Guidelines (A financial counselor can help you determine this.)
|Federal Poverty Guideline||Discount|
|0 - 250%||100%|
|251 - 400%||AGB1|
|Federal Poverty Guideline||Maximum Liability as a Percent of Household Income|
|401 - 600%||10%|
1AGB: Amounts Generally Billed. UH will never charge more than AGB for emergency or other medically necessary care for those patients who qualify for financial assistance or medical indigence.
2Patients may qualify for partial financial assistance if they can demonstrate that their medical expenses exceed an established percentage of their family income outlined above. Contact a financial assistance counselor for more information. Patients wishing to be considered for discounts under this policy must provide requested documentation of income, residence and qualifying medical expenses in a timely manner.
How to Apply for Financial Assistance
You must complete a Financial Assistance Application and submit it as directed on the application. We encourage you to submit your application as soon as possible in order to assist you in managing your medical finances. The application must be submitted within 240 days of receipt of your first post-discharge billing statement received for the service for which you are requesting financial assistance.
You also will need to provide information that will assist UH in determining your eligibility and financial assistance level. This information may include:
- Credit score
- Current state or federal tax returns
- Bank statements
- Payroll stubs
If you do not qualify for financial assistance, you may request that a financial counselor review your case to establish payment plan options with UH.
To learn more, please refer to the HCAP – Hospital Care Assurance Program Guidelines
How to Obtain a Free Copy of the Financial Assistance Policy and Application
You can obtain information about the UH Financial Assistance Program and assistance with completing the Financial Assistance Application – as well as pick up or request a free copy to be mailed to you – in the following ways:
- Access and print online:
Download the Financial Assistance Application
Download the Lake Health Financial Assistance Application
Download the Laboratory Financial Assistance Application
- By calling:
UH Financial Counselors
Monday through Friday
8 a.m. – 4:30 p.m.
In person at any UH hospital in Patient Access Services or:
UH Customer Services Center
UH Patient Accounting
20800 Harvard Avenue, Main Floor
Beachwood, Ohio 44122
Monday through Friday
8 a.m. – 5 p.m.
Right to Receive a Good Faith Estimate
Under the law, patients who don’t have insurance or choose not to use insurance may request an estimated bill that outlines their out-of-pocket costs for medical items and services before proceeding with treatment.
If you require the financial assistance information or an application in a language other than English, please contact us through one of the methods above.
Please also refer to the following translated resources: