Financial Assistance Plain Language Summary

Financial Assistance Offered

UW Medicine offers financial assistance, under its Financial Assistance Policy, to eligible patients who are unable to pay for emergency or other medically necessary care. UW Medicine provides financial assistance for any patient/guarantor whose gross family 收入 is up to 400% of the Federal Poverty Level (FPL) 和 adjusted for 家庭规模 after any third-party coverage has been exhausted. For facility 和/or professional services at Airlift 西北, Harborview 医疗 Center, 华盛顿大学医学中心, 威斯康辛大学内科医生, UW Medicine 初级护理, 和 十大正规网赌软件:

• 0% - 300% of the FPL for a 100% financial assistance discount

For facility services only with discharge dates on or after July 1, 2022 at Harborview 医疗 Center, 华盛顿大学医学中心, 和 十大正规网赌软件:

• 301% - 350% of the FPL for a 75% financial assistance discount
• 351% - 400% of the FPL for a 50% financial assistance discount

For 十大正规网赌软件, an individual who is eligible for financial assistance cannot be charged more than the amounts generally billed for emergency or other medically necessary care.

Eligibility Requirements 和 Assistance Offered

Eligibility for financial assistance is based on many factors including the nature of the condition 和 care required, insurance coverage or other sources of payment, 收入, 家庭规模, 和 any special considerations the patient or provider would like to have considered.

病人 seeking financial assistance must comply with the Financial Assistance application process. This includes submitting the patient’s W-2 statement, 当前工资单, bank statements or last year’s 收入 tax return, 和 completing the application process for all available sources of assistance, including Washington state subsidized care.

How to Apply for Assistance

The patient or any person involved in the care of the patient, including a family member or provider, can express financial concerns. The patient or responsible party will then be encouraged to complete a financial assistance application. To qualify for financial assistance, an application can be submitted at any time prior to an account receiving a court judgment.

What is Eligible for Assistance

Financial assistance is limited to medical care provided at a UW Medicine location by UW medical personnel. Expenses such as travel, 食物, 住宿, 和 durable medical equipment are not covered under the Financial Assistance policy. Prescriptions may be covered for patients up to 300% of the FPL for a 100% financial assistance discount if written by a UW Medicine provider 和 filled at a UW Medicine pharmacy (if available).

Where to Obtain Copies, Submit Documents 和 Contact Information

UW Medicine Financial Assistance Policy, Financial Assistance Application, Plain Language Summary, 和计费 & Collection Policies are available free of charge. These documents can be accessed in multiple languages online, by phone or in person. Documents are online to download or print at uwmedicine.org/financialassistance or reverse-mortgage-explained.com/financialassistance. You can ask for your copy in person or by phone from the location where you are seeking care.

For the Financial Assistance application 和 supporting documents in 英语, you can now utilize MyChart (except Airlift 西北) to submit your documents based on your care location. For all other application submissions continue to submit by mail, fax, or in person. Any information submitted for consideration will be treated as protected health information under the Health 保险 Portability 和 Accountability Act (HIPAA).