How to apply for Hospital financial assistance (Holton Community Hospital) — Jackson in Kansas

Who it's for

Holton Community Hospital offers financial assistance for emergency, urgent and medically necessary care at the hospital and its Holton, Hoyt and Wetmore family medicine clinics. Help uses a sliding scale based on household income and the federal poverty level (FPL): at or below 100% of the FPL you may get a 100% discount, and from 100% to 200% of the FPL a discount of 10% to 75%. Help may also be available for people found to be medically indigent. If you qualify, you will not be charged more than the amounts generally billed to people with insurance. Download the application, pick one up at Registration or the Business Office (1110 Columbine Drive, Holton), or call 785-364-2116 to request one. For help filling it out, call the Business Office at 785-364-9658.

What you'll need

• Financial Assistance Application

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital financial assistance (Holton Community Hospital) — Jackson. 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 — 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)