Difficulty Paying Your Hospital Bill
We offer financial assistance for those who are deemed to be in financial need due to a personal lack of finances. Each applicant (regardless of race, creed, gender, age, or national new in) may apply for financial assistance. In order to see if you qualify, you must complete a written application and comply with program requirements. Your eligibility depends on completing the entire request process.
Options available through our Patient Financial Assistance Program include:
- Establishing a payment plan
- Determining your eligibility for a reduction in the amount you owe for some services
- Helping you apply for Medicaid
- Determining your eligibility for KHCP
- Determining your eligibility for in-house charity care
In order to determine what you qualify for, we will need information about your job, income, insurance coverage, and family size. This helps us determine the appropriate program that you may qualify for. We realize some of the questions we must ask may be sensitive. However, the information we request is necessary so we can try to help you.
You have our commitment that we will respect you and your privacy during this process. We believe that no person should avoid seeking care due to an inability to pay.
Downloadable Forms
- Providers Covered by the Financial Assistance Policy – Spanish
- Providers Covered by the Financial Assistance Policy – English
- Financial Assistance Eligibility Grid – Spanish
- Financial Assistance Eligibility Grid – English
- Plain Language Summary – Spanish
- Plain Language Summary – English
- Billing & Collection Policy – Spanish
- Billing & Collection Policy – English
- Financial Assistance Policy – Spanish
- Financial Assistance Policy – English
- Financial Assistance Application – Spanish
- Financial Assistance Application – English