How to apply for Hospital Financial Assistance (ProHealth Waukesha Memorial Hospital) — Waukesha in Wisconsin

Who it's for

Uninsured and underinsured residents of Waukesha County can apply for financial assistance (charity care) at ProHealth Waukesha Memorial Hospital for emergency and medically necessary care. ProHealth Care's financial assistance program serves its service area — parts of Waukesha, Dodge, Jefferson, Racine, and Walworth counties — based on income guidelines. Discounts are based on household size and income compared with the Federal Poverty Level.

What you'll need

• Completed ProHealth Care financial assistance application
• Proof of income: last year's tax return and W-2, and pay stubs for the last 90 days
• Bank statements
• If you own a home: property tax bill or real estate assessment and mortgage statement

Where to apply

What to say when you call

"Hello, I'm calling to ask about Hospital Financial Assistance (ProHealth Waukesha Memorial Hospital) — Waukesha. 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 ProHealth Care financial assistance application, proof of income: last year's tax return and W-2, and pay stubs for the last 90 days, bank 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

every 3 months (an approval covers care for three months from the date of service; reapply after that)