How to apply for Holzer Health System (Gallipolis) — Financial Assistance (Gallia County) in Ohio

Who it's for

Gallia County hospital safety net: Gallia = Holzer Health System (Holzer Hospital, Gallipolis) — the regional Ohio River anchor, with Pleasant Valley (WV) across the river. Ohio's Hospital Care Assurance Program (HCAP) requires hospitals receiving HCAP funds (essentially all Ohio acute-care hospitals) to provide basic, medically necessary hospital-level services free of charge to Ohio residents at or below 100% FPL; each hospital's own Financial Assistance Program (typically sliding to 200-400% FPL) layers above HCAP. Apply by returning a Financial Assistance Application (www.holzer.org/financial-assistance) to a Holzer Financial Advocate office in Gallipolis or at Holzer Medical Center - Jackson. Questions: Financial Advocacy Department, 740-446-5252 or toll free 855-446-5252.

What you'll need

• Completed Holzer Financial Assistance Application
• Number of people in your household
• Proof of total gross income for the 3 months before the date of service
• Be ready to apply for Ohio Medicaid or other public assistance if eligible

Where to apply

What to say when you call

"Hello, I'm calling to ask about Holzer Health System (Gallipolis) — Financial Assistance (Gallia 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 completed Holzer Financial Assistance Application, number of people in your household, proof of total gross income for the 3 months before the date of service — 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-encounter or annual