How to apply for Hospital Financial Assistance (Norman Regional) — Cleveland

Who it's for

Norman Regional Health System in Norman has a Charity Care Financial Assistance program for patients who meet federal poverty guidelines. Applications are reviewed based on income, assets and family size. The policy's sliding scale gives a 100% discount at 0%-180% of the Federal Poverty Guidelines, 90% at 181%-200%, 80% at 201%-220%, and 70% at 221%-300%. Read the policy first, then mail the signed application to Patient Financial Services, 3300 HealthPlex Pkwy, Norman, OK 73072, or drop it off at the business office at 901 N. Porter Ave. For questions, call 405-307-5831.

What you'll need

• Signed Charity Care Financial Assistance Application
• Copy of your most recent Federal Income Tax return for each wage earner (or W2s or Form 1099s if you did not file)
• A current paycheck for each household member
• Three months (90 days) of checking account statements and a current savings account statement

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Norman Regional) — Cleveland. 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 signed Charity Care Financial Assistance Application, copy of your most recent Federal Income Tax return for each wage earner (or W2s or Form 1099s if you did not file), a current paycheck for each household member — 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)