We are a charitable healthcare organization that offers services throughout northeast Nebraska treating patients, regardless of their financial status. We offer financial assistance for these services in the form of free or discounted care to those patients who may have an inability to pay their bills.
Applying for Financial Assistance
In order to be considered for financial assistance, the patient or their family representative must complete an application and provide information that supports their financial need. In reviewing the application, we will consider the following factors:
- Have all means of payment, such as private insurance coverage or coverage through Medicare, Medicaid or other government programs, been exhausted?
- Are there other circumstances or resources that may affect the patient's ability to pay for care?
- What is the patient’s family gross income as it compares to the most recently published Federal Income Guidelines?
- What is the size of the patient’s family?
Please utilize our Financial Assistance Checklist to help you through the application process.
Faith Regional Financial Assistance Applications:
- Financial Assistance Program Application
- Aplicación de Programa de Ayuda Financiera (Spanish)
For questions regarding Financial Assistance or billing, contact (402) 644-7145.
Additional Financial Assistance Programs and Applications
Medical Advocacy Services for Healthcare (M.A.S.H.): Faith Regional Health Services provides a free service to help uninsured patients determine their eligibility for public benefits programs. These are federal, state, county, or local programs designed to provide financial aid to people unable to meet their financial obligations related to a hospital stay. Examples of this would include Supplemental Security Income, Medicaid, and County Medical Programs. Assistance with Health Care Reform insurance process is also available. There are many differences among public benefits programs such as eligibility criteria, funding, duration, etc. Our M.A.S.H. Program patient advocate will ask you for information on the medical services provided at the hospital, your income, your family, and your citizenship to determine the program for which you are best suited. All completed applications are forwarded to the proper government agency that is responsible for final determination of your eligibility–at no cost to you. Acting on your behalf, M.A.S.H. will track your application until a decision is made. To learn more and get connected to a M.A.S.H. representative contact (402) 644-7566.
Medicaid: Medicaid is a "Federal/State" program that provides assistance to people with limited resources to: Children and teens age 18 and under, and pregnant women with gross monthly family income at or below certain amounts. Assets are not counted. Parents living with their children and teens age 18 and under with a monthly family income at or below certain levels, and with certain assets of $2,000 or less. Click here to apply online for Medicaid.
Every Woman Matters Program: Every Woman Matters is a program offered through the Nebraska Department of Health and Human Services that can help women ages 40 through 74 pay for certain health check-ups including screening mammograms. Click here to learn more and download an enrollment form.