How to apply for Hospital Charity Care (Pemiscot Memorial Health Systems, Hayti) — Pemiscot in Missouri

Who it's for

Pemiscot Memorial Hospital in Hayti is the county's publicly owned hospital. Its Charity Care Policy states: "It is the policy of Pemiscot Memorial Health Systems to render medical care to all patients regardless of their ability to pay. The Federal Poverty Income Guidelines, as updated on an annual basis from the Department of Health and Human Services, will be used in determining the level of obligation for each charity care patient." A Charity Evaluation Review Form is completed, annual income is verified from the prior-year tax return, most recent W-2, the last three pay stubs, or the Social Security check amount, and the patient receives a Determination of Eligibility letter with the account balance adjusted accordingly. Call the hospital at 573-359-1372 (billing department 573-359-3416) and ask for the Charity Evaluation Review Form.

What you'll need

• Completed Charity Evaluation Review Form
• Prior-year federal income tax return or most recent W-2
• Last three pay stubs, or the amount of your Social Security check

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Charity Care (Pemiscot Memorial Health Systems, Hayti) — Pemiscot. 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 Charity Evaluation Review Form, prior-year federal income tax return or most recent W-2, last three pay stubs, or the amount of your Social Security check — 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)