Memorial Primary Care Financial Assistance Availability

Availability of Financial Assistance

All patients seeking healthcare services at Memorial Primary Care are assured that they will be served regardless of ability to pay. No one is refused service because of lack of financial means to pay. This program is designed to provide free or discounted care to those who have no means, or limited means, to pay for their medical services (uninsured or underinsured).

Memorial Primary Care Practices will offer a Sliding Fee Discount Program Policy to all who are unable to pay for their services. Memorial Primary Care Practices will base program eligibility (download Eligibility Application Checklist) on a person’s ability to pay and will not discriminate on the basis of an individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity.

Financial assistance is not available when the patient chooses to pay the “self-pay” rate that is available when the payment is made prior to receiving services.

Discounts are offered based upon family/household size and annual income (download Memorial Primary Care Sliding Fee Discount Application).

A sliding fee schedule is used to calculate the basic discount and is updated each year using the Federal Poverty Guidelines.

Patients or responsible parties will be considered for discounts:

• Up to 100% if the total household income is less than 200% of the Federal Poverty Guidelines (FPG)
• Up to 100% if the total balance due is more than 25% of the total household’s annual income
• Up to 100% if the total household’s annual income is not more than 4 times the FPG for a family of 4
• From 73% to 90% when the total household’s income is between 201% and 400% of the FPG

Review Process

The patient or responsible party has up to 120 days to provide all of the requested information. Memorial Healthcare System will then review the information and determine whether the patient or responsible party meets the financial assistance guidelines. Memorial Healthcare System will tell the patient or responsible party in writing whether or not they qualify under the Financial Assistance Policy guidelines.

If a patient or responsible party is eligible to receive financial assistance under the Financial Assistance Policy, he or she will not be charged more than the Amounts Generally Billed (AGB). At Memorial Healthcare System, the AGB is determined through the “look-back method” which calculates the average percentage of charges insurance companies pay and applies that percentage to the patient’s accounts. The calculation is available in the Financial Assistance Policy or in the Registration areas of any of the facilities.

Physicians Offering Financial Assistance

Memorial Primary Care doctors that are a part of our Memorial Physician Group offer financial assistance. See the full list of Memorial Physician Group doctors or when searching for a physician, look for the Memorial Physician Group logo.

View the list of physicians who offer and do not offer financial assistance (PDF).

The Memorial Primary Care Financial Assistance Policy, Financial Evaluation Form, and Evaluation Checklist are available.