How to apply for Northern Arizona Healthcare Financial Assistance — Flagstaff Medical Center (Coconino County)

Who it's for

Northern Arizona Healthcare offers financial assistance for medically necessary care at multiple facilities: Flagstaff Medical Center, Verde Valley Medical Center, NAH–Sedona, NAH–Village of Oak Creek, NAH–Camp Verde, and EntireCare Rehab & Sports Medicine. Patients who show financial need based on the federal poverty level (gross income less than 400% FPL), and who are ineligible for or not fully covered by Medicaid (AHCCCS), may have hospital charges reduced or waived. Call 928-773-2025 to apply.

What you'll need

• Financial assistance application
• A complete copy of your signed prior year federal tax returns
• Two months of personal bank statements for all checking and savings accounts
• Proof of total household income (e.g., two consecutive paycheck stubs or employer letter, SSA 1099 benefits letter and/or pension statement, unemployment payment statements, or other income sources)

Where to apply

What to say when you call

“Hello, I'm calling to ask about Northern Arizona Healthcare Financial Assistance — Flagstaff Medical Center (Coconino County). 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 financial assistance application, a complete copy of your signed prior year federal tax returns, two months of personal bank statements for all checking and savings accounts — 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

per application