Financial Assistance Policy – Plain Language Summary
Monument Health offers a Financial Assistance Program to patients who live in our service area that have health care needs and are uninsured, underinsured or are not eligible for a government or any other insurance programs. Under the Monument Health Financial Assistance policy, you may be eligible for a partial or full reduction of your bill.
Eligibility is based upon your total household size and income, when compared to the federal poverty guidelines. Verification of your household income is required to determine eligibility. Our patients must also apply for Medicaid, employer available insurance, Healthcare Marketplace Insurance and any other available insurance offered, and be denied coverage.
To apply for financial assistance, you must complete a Financial Assistance Application. Free copies of the financial assistance policy and application forms are available below. These forms are available in many languages upon request. We also have designated caregivers available to assist you through the application process.
The following options are available to obtain and submit the application.
- MyChart: With MyChart, you can securely apply for assistance through our online patient portal.
- Telephone: Call 605-755-7500 to request a copy be mailed to your home.
- In-Person: Any Admission/Registration or Emergency Department within any Monument Health Hospital or Clinic. Search for a Monument Health facility near you. You may also contact 605-755-7500 for the address of a hospital or clinic.
You will not be charged more for emergency or medically necessary care than the current Medicare rates for the amount you owe. Monument Health will not engage in extraordinary collection activities, such as liens or garnishments, before making reasonable efforts to determine eligibility for Financial Assistance and a partial or full reduction of a patient’s billing.
Resources (English)
Financial Assistance Application
Monument Health Charity Care Discounting Policy English v2024
Monument Health Plain Language Summary English v202009
Attachment A – Charity Discounting Program Exclusions English v20221003
Attachment B – Charity Discounting Program Definitions English v20221003
Attachment C – Charity Discounting Program Service Area English v20221003
Attachment D – Charity Discounting Program Sliding Payment English v02202024
Providers covered by the Charity Care Discounting Policy
Providers not covered by the financial assistance policy
Resources (Spanish)
Politica de Descuentos de Ayuda Benéfica de Monument Health
Monument Health Plain Language Summary Spanish v202009
Anexo A – Exclusiones del programa de Ayuda Económica
Anexo B – Definiciones del Programa de Ayuda Económica
Anexo C – Código Postal del Área de Servicio de Ayuda Económica
ATTACHMENT D – Charity Discounting Program Sliding Payment Spanish v02202024
Proveedores cubiertos por la política de descuentos de atención caritativa
FREQUENTLY ASKED QUESTIONS
What are the financial assistance programs?
What is the difference between medically and financially necessitous patients?
A medically necessitous patient is a person who has experienced a sudden loss of income of at least 90 days due to illness. A financially necessitous patient is a person who does not have insurance and cannot afford to pay for part or all of their health care.
Who is eligible for Monument Health's Financial Assistance programs?
Depending on your financial circumstances, you might be asked to provide financial information regarding your income. Your financial assets and liabilities may also be considered when determining your ability to pay. Monument Health also uses income limits issued by the U.S. Department of Housing and Urban Development to determine a person’s eligibility for financial assistance.
What services are covered under the Financial Assistance Program?
Only medically necessary care received at a Monument Health hospitals is covered on Monument Health’s Financial Assistance Program. A list of excluded services is available upon request.
Depending on the services you needed, you might receive several other bills. If you had certain tests or procedures, you also might receive a separate bill from doctors who are not employees of Monument Health, such as an anesthesiologist, emergency medicine physicians, radiologist or pathologist.
Who can help me find a financial assistance program to fit my needs?
Patient Advocates will help you understand the cost of care, determining what will be covered by insurance, explaining payment options, and identifying payment resources.
Am I responsible for my bill while I am applying for assistance?
Yes, you are responsible for your bill until eligibility has been determined.
Contact Us
Patient Financial Services
(605) 755-7500