Financial Assistance for Those Unable to Pay the Full Cost of Care
Saint Clare’s Health System is a part of Prime HealthCare, a for
profit health organization with a longstanding commitment to assist those
who seek our care, regardless of ability to pay.
If you are unable to pay for all or part of the care you receive from our
hospital, you may be eligible for free or discounted services. Please
read the information below to understand:
- How eligibility for financial assistance is determined
- How to apply for financial assistance.
This information is a summary of the national Prime policy. Please
click here to read the policy in full.
PLEASE NOTE: Any patient seeking emergency care will be treated without
regard to ability to pay.
How eligibility for financial assistance is determined
To determine your eligibility for financial assistance, we consider:
The medical necessity of services received. In short, medically necessary
services save your life, make you well, or prevent a medical condition
from becoming worse. There is a detailed definition of medically necessary
services in the Prime policy.
Medical necessity will be determined by a physician. In determining medical
necessity, we follow all requirements of the federal Emergency Medical
Treatment and Active Labor Act and applicable laws and regulations.
- Your ability to pay for the services. We look at income, family size, available
resources and expected future income.
You may qualify for 100% of your care provided for free, or a discounted
charge under one or both of these criteria:
· Your family income is low. Free care may be available to patients
with family income less than or equal to 130 percent of the Department
of Housing and Urban Development (HUD) very low income guidelines for
the area; and/or
· You are considered medically indigent. This means that paying
the full cost of your medical care, after any health insurance payment,
would cause you to become impoverished. This could apply if you are uninsured,
underinsured, or suffer a catastrophic illness.
How to apply for financial assistance
When you are registered as a patient, we will ask about your coverage for
health care services. If you don’t have coverage or it is not likely
to be sufficient, we will either give you a packet of information that
covers our financial assistance policy or offer the immediate assistance
of a financial counselor, who will go over the financial assistance application with you.
You will need to complete the Financial Assistance Application form, provide
all information it requests, and submit it to us.
If it is determined you are eligible for assistance, we will notify you
and let you know how much assistance is available. If it is determined
you are not eligible for assistance, we will let you know that in writing
and give a brief explanation of the reason.
It’s important to note that if you do not have insurance, you will
not be charged more for services than the amount generally billed to those
who have insurance.
Once again, this is a summary of the Prime national financial assistance policy.You can read the full policy here.
If you have any questions about qualifying or applying for financial assistance,
please contact the Financial Assistance office at Karla Baez at (973)
771-5911 or via email
FinancialAssistance@primehealthcare.com.. Karla Baez would need access to this email.