How to apply for Hospital financial help (Ashley Regional Medical Center) — Uintah in Utah
Ashley Regional Medical Center (Lifepoint Health)
Who it's for
Ashley Regional Medical Center in Vernal reviews patients for special financial consideration (charity care) on hospital bills. Fill out the Special Financial Consideration Application completely and attach the papers it asks for: a full signed copy of your federal tax return with all schedules, pay stubs for the last three months, and any other papers that back up what you report. The hospital checks the information and makes a decision. Return the application to Ashley Regional Medical Center, 150 West 100 North, Vernal, UT 84078. For questions, call 435-781-6859.
The hospital decides who gets special financial consideration and how much; the application does not publish income limits.
People who qualify for one senior program often qualify for others. See everything you may qualify for — free, no SSN, about five minutes.
Discover my benefitsWhat you'll need
- Completed Special Financial Consideration Application
- Signed federal tax return with all schedules
- Pay stubs for the previous three months
- Other papers that support the information you give
Where to apply
Apply online: official application
By phone: 1-435-781-6859
What to say when you call
"Hello, I'm calling to ask about Hospital financial help (Ashley Regional Medical Center) — Uintah. 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 completed Special Financial Consideration Application, signed federal tax return with all schedules, pay stubs for the previous three months — 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)
Not sure if you qualify? Run a free check first.
Discover my benefitsNot legal or financial advice. The agency makes the final eligibility decision.