Benefits · Healthcare
How to apply for Hospital Financial Assistance (SSM Health St. Agnes Hospital) — Fond du Lac
SSM Health St. Agnes Hospital
Who it's for
Uninsured and underinsured residents of Fond du Lac County can apply for financial assistance (charity care) at SSM Health St. Agnes Hospital for emergency and medically necessary care. SSM Health provides 100% free care at or below 200% of the Federal Poverty Level plus automatic uninsured discounts. Discounts are based on household size and income compared with the Federal Poverty Level.
Charity care is income-based and set by the hospital's financial assistance policy; the hospital makes the final award decision, so this shows as a may-qualify result.
What you'll need
- Proof of household income (tax return, pay stubs, or benefit award letter)
- Proof of family/household size
- Identification
Where to apply
Apply online: official application
By phone: 1-888-918-3512
What to say when you call
"Hello, I'm calling to ask about Hospital Financial Assistance (SSM Health St. Agnes Hospital) — Fond du Lac. 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 proof of household income (tax return, pay stubs, or benefit award letter), proof of family/household size, identification — 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)
Not sure if you qualify? Run a free check first.
Find my benefitsNot legal or financial advice. The agency makes the final eligibility decision.