金融援助

If payment of your healthcare expenses could create a financial hardship for you, you may qualify for charitable care, also referred to as charity care — the free or discounted medical care provided to low-income, uninsured or underinsured patients. Our 金融援助 Program is designed to provide eligible patients with full or partial discounts on their bills for emergency or medically necessary healthcare. This is a summary of 皇冠app’s 金融援助 Policy and the financial assistance application process. Applications can be obtained online or by visiting or calling our Financial Counseling at (603) 227-7101 or (800) 562-1542.

项目的资格

• The program provides free care for those who have tried all other payment options (e.g., Medicare, Medicaid, The Health Insurance Marketplace) and:
  • Have a household income at or below 225 percent of the U.S. Federal Poverty Guidelines;
  • Have submitted a properly completed financial assistance application along with the required documentation.

This reduction applies to uninsured and insured patients who owe balances after insurance payments have been made.

• The program also includes catastrophic assistance for uninsured patients with household income between 225 percent and 500 percent of the U.S. Federal Poverty Guidelines who have experienced a medical hardship and owe large medical bills.
• There are certain services not eligible for financial assistance, such as cosmetic services, reproductive medicine or elective non-covered services as specified by Medicare and other third-party cover年龄 guidelines.
• No person eligible for financial assistance will be charged more for care than amounts generally billed to individuals who have insurance covering emergency or other medically-necessary care.

访问 & Requesting 金融援助 Information

Besides accessing information about our 金融援助 Program on our website, you can also access it in the following ways:

• Request the information in writing by USPS mail or by visiting a 皇冠app Financial Counselor at 普莱森街250号, 康科德，NH 03301;
• Request the information directly by calling (603) 227-7101 or sending an email request to financialcounseling@crhc.组织;
• Request a financial assistance application at any check-in or registration area at any of our locations.

如何申请

• Complete a financial assistance application and submit it along with the following:
  • Complete a copy of your most recent Federal Income Tax Return and all schedules. Include copies of last year's W-2 forms;
  • Copies of the three most recent, paycheck stubs or a statement from the employer;
  • Copy of your most recent bank statement (e.g., savings, checking, money market, IRA, 401K, etc.);
  • Copies of unemployment, disability compensation benefits statements;
  • Copies of social security or pension benefit income;
  • Copy of food stamp allocation;
  • Copies of government assistance notices (including the Department of Health & 人类服务).

If you do not have all of these documents call (603) 227-7101 and speak with one of our financial counselors.

决定 & 通知

Every effort is made to finalize the decision after receipt of a complete application. 决定s are reviewed and approved by either a supervisor or a director. 通知 of a decision is sent in writing.

皇冠app will not discriminate in the determination of financial assistance eligibility on the basis of race, color, 民族起源, 性取向, 婚姻状况, 信条, 年龄, 性别或残疾.

Availability of Translations

Our financial assistance policy, application form and plain langu年龄 summary can be offered in English and Spanish or any other langu年龄 upon request. For more information, please call (603) 227-7101.