How to apply for Hospital Financial Assistance (Stilwell Memorial Hospital) — Adair

Who it's for

Stilwell Memorial Hospital, now a Rural Emergency Hospital with a 24/7 emergency room, gives free or discounted care for eligible emergency and medically necessary hospital services. Household income at or below 200% of the federal poverty guidelines (FPG) gets a 100% discount; 201%-225% gets 80%; 226%-250% gets 60%; 251%-300% gets 40%; and 301%-350% gets 20%. Having Medicare or Medicaid does not automatically stop you from qualifying. Fill out the Financial Assistance Application, include the documents asked for to verify income and household, and turn it in at the Business Office, 1401 W. Locust St., Stilwell, or by mail. Call 918-696-3101, Monday-Friday, 8:00 a.m.-4:30 p.m.

What you'll need

• Completed Financial Assistance Application
• Documents to verify income and household information

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Stilwell Memorial Hospital) — Adair. 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 Financial Assistance Application, documents to verify income and household information — 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)