How to apply for Hospital financial assistance (Burgess Health Center (Onawa)) — Monona in Iowa

Who it's for

Burgess Health Center in Onawa has a Financial Assistance Program that lowers prices on office visits and services at Burgess Health Center and Burgess Clinics for people who qualify. It is based on family income. You may qualify with or without insurance, and even if you have Medicare or Medicaid. Specialists who bill separately are not included. To apply, turn in a completed Financial Assistance application (ask at any front desk or print one), a copy of the front page of your latest income tax return or three months of pay stubs for each working family member, and your recent Medicaid application if you have one. Call 712-423-2311.

What you'll need

• Completed Financial Assistance application
• Front page of your most recent income tax return showing annual gross income, or three months of pay stubs for each working family member
• Your recent Medicaid application, if you have one

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital financial assistance (Burgess Health Center (Onawa)) — Monona. 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, front page of your most recent income tax return showing annual gross income, or three months of pay stubs for each working family member, your recent Medicaid application, if you have one — 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