How to apply for Hospital financial assistance (Bear River Valley Hospital) — Box Elder in Utah

Who it's for

Bear River Valley Hospital in Tremonton is part of Intermountain Health, which gives financial assistance to eligible patients who need medical care. Help is based on family size and gross yearly household income, for incomes within 500% of the current Federal Poverty Guidelines. People with higher incomes can be reviewed for medical hardship. Eligible patients are not charged more for emergency or other needed care than the amounts generally billed to insured people, and no one who needs emergency care is turned away for not being able to pay. Download the application and email, fax, mail or bring it with your documents to an Eligibility Counselor at an Intermountain facility, or mail it to Financial Assistance, PO BOX 27327, Salt Lake City, Utah 84127. You can also apply in person at your local hospital. For questions, call a financial counselor at 866-415-6556.

What you'll need

• Intermountain financial assistance application form
• Supporting documents listed in the application form

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital financial assistance (Bear River Valley Hospital) — Box Elder. 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 intermountain financial assistance application form, supporting documents listed in the application form — 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)

Related programs

Other help that people in the same situation often look at.

• HealthcareCommunity Health Center Sliding Fee DiscountHealth Resources and Services Administration (HRSA), Health Center Program (delivered by local community health centers)
• HealthcareState Health Insurance Assistance Program (SHIP)Administration for Community Living (delivered locally by state SHIP offices)
• Medicare SavingsMedicare Savings Programs in Utah (QMB, SLMB, QI): help paying Medicare costsUtah Department of Health and Human Services (DHHS), Medicaid; eligibility decided by the Department of Workforce Services (DWS)
• Health CoverageUtah Medicaid for people who are aged (65+), blind, or disabledUtah Department of Health and Human Services (DHHS), Medicaid; eligibility decided by the Department of Workforce Services (DWS)

See all programs in Box Elder County →