How to apply for Hospital Financial Assistance (Vaughan Regional Medical Center) — Perry

Who it's for

Perry County has no hospital. Vaughan Regional Medical Center in Selma (Dallas County) is the area's regional hospital. It has a Financial Assistance Program that can cover all or part of hospital bills (not bills from doctors, radiology, or ambulance). Fill out the Financial Assistance Application, sign it, and return it with the supporting documents within 14 days of getting it, or it will be denied. Call Customer Service at 334-418-4380 with questions.

What you'll need

• Signed federal tax return from last year, with W-2s and 1099s
• Current pay stubs for each working household member
• Bank statements for the current month and past 5 months
• Social Security, VA, or pension benefit statements for the current month and past 11 months
• Food stamp notice, if any

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Vaughan Regional Medical Center) — Perry. I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need signed federal tax return from last year, with W-2s and 1099s, current pay stubs for each working household member, bank statements for the current month and past 5 months — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Renewals

annual (reapply per policy)