Financial Assistance
Charity CareWashington State requires all hospitals to provide financial assistance to people and families who meet certain income requirements. You may qualify for free care or reduced-price care based on your family size and income, even if you have health insurance.
- Patients with income between 0%-200% the Federal Poverty Level are eligible for a 100% discount
- Patients with income between 201%-250% the Federal Poverty Lines are eligible for a 75% discount.
- Patients with income between 250%-300% the Federal Poverty Lines are eligible for a 50% discount.
Patients over 300% of the Federal Poverty Level may be considered for Catastrophic Charity Care if medical expenses are equal or greater than 20% of the family’s annual gross income. Please contact Patient Financial Services for more details.
What does financial assistance cover? Financial assistance covers medically necessary services provided by our Hospital or one of our Clinics, depending upon your eligibility. Financial assistance may not cover all health care costs, including services provided by other organizations.
How is the application processed? In order for your application to be processed, you must:
- Provide us information about your family: Fill in the number of family members in your household (family includes people related by birth, marriage, adoption, or who live together)
- Provide us information about your family’s gross monthly income (income before taxes and deductions)
- Provide documentation for family income.
- Attach additional information if needed
- Sign and date the form
Note: You do not have to provide a Social Security number to apply for financial assistance. If you provide us with your Social Security number it will help speed up processing of your application. Social Security numbers are used to verify information provided to us. If you do not have a Social Security number, please mark “not applicable” or “NA.”
Mail or fax completed application with all documentation to: Patient Financial Services, Lincoln Hospital, 10 Nicholls St, Davenport, WA 99122. Fax: (509) 725-2112, Attention: Self-Pay Specialist . You may submit your application through MyChart or submit your application to the Admitting Desk at Lincoln Hospital, 10 Nicholls St., Davenport WA.
We will notify you of the final determination of eligibility and appeal rights, if applicable, within 14 calendar days of receiving a complete financial assistance application, including documentation of income. By submitting a financial assistance application, you give your consent for us to make necessary inquiries to confirm financial obligations and information.