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

Who it's for

Jackson County hospital safety net: Jackson = Holzer Jackson (Holzer Health System) — county hospital, with Adena (Chillicothe) reaching the north. 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 — Jackson — Financial Assistance (Jackson 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