How to apply for Hospital financial assistance (Republic County Hospital) — Republic in Kansas

Who it's for

Republic County Hospital in Belleville has a Financial Assistance Program for emergency and medically necessary care for people who are uninsured, underinsured or have low income. If your household income is less than 200% of the federal poverty level, you may get 100% financial assistance. You can apply in person at admissions or patient financial services, by phone at 785-527-2254, by mail or on the hospital website. You have at least 240 days after your first bill to apply.

What you'll need

• Income tax returns with W-2 or 1099 forms for the past 2 years
• Most recent 90 days of pay stubs, Social Security checks or unemployment checks
• Most recent 60 days of bank and investment statements
• Proof of household size

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital financial assistance (Republic County Hospital) — Republic. 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 income tax returns with W-2 or 1099 forms for the past 2 years, most recent 90 days of pay stubs, Social Security checks or unemployment checks, most recent 60 days of bank and investment statements — 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)