How to apply for Hospital Financial Assistance (Chicot Memorial Medical Center) — Chicot in Arkansas

Who it's for

Chicot Memorial Medical Center in Lake Village has a Financial Assistance Program for patients who are uninsured or underinsured and cannot pay for some or all of their care because of real financial need. Patients who are not eligible for Medicaid or another funded program can be considered, and people with a high deductible can also apply. You must fill out an application and provide documents to qualify. No one is denied care because they cannot pay. A prompt-pay discount may apply if you pay in full within 45 days of the date of service. For help or questions, call 870-265-9200.

What you'll need

• Completed financial assistance application
• Supporting documentation (call to ask what to bring)

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Chicot Memorial Medical Center) — Chicot. 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 completed financial assistance application, supporting documentation (call to ask what to bring) — 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)