How to apply for Hospital Financial Assistance (Fairview Regional Medical Center) — Major in Oklahoma

Who it's for

Fairview Regional Medical Center in Fairview, a critical access hospital, has a charity care policy based on family size and gross income compared with the federal poverty guidelines. Patients in households below 200% of the poverty level get a sliding-scale discount, and those below 100% pay only a small fixed fee. Charity care covers medically necessary clinic visits and in-house lab and X-ray services, and it can also cover balances from the 90 days before you apply. The hospital may ask for recent tax returns, last year's W-2s, a Social Security benefit letter, or your 3 most recent pay stubs. Uninsured patients who are not approved for charity care can get a self-pay discount and may set up monthly payments. Applications are available at the hospital Business Office, 523 East State Road, Fairview, Monday through Friday, 8 a.m. to 5 p.m. Call 580-227-3721 to confirm the current policy before you apply.

What you'll need

• Financial Assistance Application
• Proof of household income, such as recent tax returns, last year's W-2s, a Social Security benefit letter, or the 3 most recent pay stubs

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (Fairview Regional Medical Center) — Major. 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 financial Assistance Application, proof of household income, such as recent tax returns, last year's W-2s, a Social Security benefit letter, or the 3 most recent pay stubs — 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)