Patient Financial Assistance - Mayo Clinic Health System - Fountain Centers
300 State Avenue, Faribault, MN 55021
Eligibility
Open to all Mayo Clinic Health System patients
Required documents
Application form
statement describing need for financial assistance
tax returns for previous 2 years
W-2 or unemployment status
Hours
Vary by site
(800)533-1616
Voice·
Patient Account Services
Application process
- Call
- Mail application form and supporting documents to 200 first street SW, Rochester, MN 55905: https://mcforms.mayo.edu/mc4200-mc4299/mc4244-15.pdf
- Submit application and supporting documents through Patient Online Services: https://onlineservices.mayoclinic.org/content/staticpatient/showpage/patientonline
Service area
Blue Earth County, MN
Freeborn County, MN
Martin County, MN
Mower County, MN
Olmsted County, MN
Rice County, MN
Steele County, MN
Wabasha County, MN
Waseca County, MN
Other Information
Program Fees
- Sliding Scale/Reduced Fee
Patients who need to speak with a financial counselor, need cost of care estimates or determine if they may qualify for financial assistance to pay for procedures may reach out about options. Financial counselors can help individuals understand patients' responsibilities and may offer no-interest payment plans. Other options may include:
?- Discount Program: Individuals who are uninsured or underinsured and have incomes less than 250% of the Federal Poverty Guideline may be eligible for getting help to pay their medical bill
?- Elevate Patient Financial Solutions: Help patients without medical insurance find resources to help pay for medical bills
Last Assured
02/11/2026
Providing organization
Mayo Clinic Health System - Fountain Centers
Addiction treatment center that support individuals and families who are facing substance use challenges