How to apply for Hospital Financial Assistance (Field Health System) — Wilkinson in Mississippi

Who it's for

Field Health System in Centreville has a Financial Hardship Program. The hospital and its clinics give care for free or at a lower cost based on your ability to pay. Discounts are for people who are uninsured or underinsured and are based on family size and yearly income, using a sliding fee schedule tied to the Federal Poverty Guidelines. Fill out the Financial Hardship Application with proof of all household income and the names and ages of everyone in your home. Return it within 15 days to Field Health System or one of its clinics in Catchings, Centreville, Gloster or Liberty, or the Field Specialty Clinic. Fill out a new form if your household size or income changes. Call the Financial Counselor at 601-890-0533.

What you'll need

• Field Health System Financial Hardship Application
• Proof of all household income, such as pay stubs, Social Security or SSI checks, interest income, royalties, rent and child support papers
• Names and ages of everyone living in the household

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Field Health System) — Wilkinson. 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 field Health System Financial Hardship Application, proof of all household income, such as pay stubs, Social Security or SSI checks, interest income, royalties, rent and child support papers, names and ages of everyone living in the household — 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

reapply when household size or income changes