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NOTE: Funding is currently not available at this time. Individuals are still encouraged to apply. Cash-grant program for adults with low incomes experiencing household emergencies. Adults can receive assistance once every 12 months. The assistance received must resolve the crisis. Adults must use their own money first. The amount of assistance provided might not cover the entire emergency, but it can help. Short-term, one-time grant assistance for persons in a financial crisis because of fire, flood, storm, illness, accident, theft, utility shut-off, eviction, foreclosure, moving expense, necessary home repairs, or need for furniture or appliance replacement or repair.

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 what patients' responsibilities will be, 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 help to pay their medical bills

• Elevate Patient Financial Solutions: Help patients without medical insurance find resources to help pay for medical bills

Provide assistance and support to veterans and their dependents in obtaining benefits through county, state, and federal programs. Benefits include:

• Chemical dependency treatment

• Coordinate transportation to VA Medical Center

• Death and burial benefits

• Dental and optical vouchers for both qualified veterans and their spouses

• Dependency and indemnity compensation (DIC)

• Discharge review

• Education and training

• GI Bill education training

• GI life insurance

• Home loan guaranteed by the USDVA

• Outpatient medical care

• Non-service related disability pension

• Service related disability compensation

• Survivors and dependents education

• Vocational rehabilitation for the disabled

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:

• Our Charity Care: Patients who are unable to pay for all or part of their health care services may apply for financial assistance by completing and returning this form. Patients and families who meet certain income requirements may qualify for free care or reduced-price care based on their family size and income, even if they have health insurance.

Contracts with Change Healthcare to assist patients with Minnesota Healthcare Program or Hennepin Healthcare Charity Care applications. Representatives can be accessed at the Clinic & Specialty Center, Whittier Clinic, or Brooklyn Park Clinic. MNsure Enrollment On the MNsure marketplace, individuals can find, compare, and choose healthcare coverage, including commercial health insurance plans and low-cost or free plans through government programs. A financial counselor can help complete the online application. If eligible for a government program such as Medical Assistance or Minnesota Care, individuals may enroll through MNsure year-round. Uncompensated Care Enrollment If not eligible for coverage through MNsure, individuals may qualify for the Uncompensated Care discount program. The program provides discounted care based on family size and annual household income. A financial counselor can answer program questions and help complete the application. Find a list of individual Hennepin Healthcare providers covered by the HHS FAP here. The following list of Clinics/Providers are not covered by the HHS FAP. This list is subject to change. Non-Covered Clinics/Providers Associated Nephrology Consultants Colon and Rectal Surgery Associates, Ltd. University of Minnesota Physicians (pediatric trauma services, neuro-interventional radiologic services)

Offers a discount program for eligible patients and a payment plan option for any balance not covered by the discount. The program cannot be used for dental and pharmacy bills and charges. Program assistance is based on:

• Assets, such as property or savings accounts
• Family size
• Income
• Liabilities, such as bills or regular payments due

Individuals may apply even if they have insurance coverage.

Fairview Financial Assistance Program covers charges for most Fairview hospital-based and clinic-based services. Charity Care may be available for households with income at or below 400 percent of the Federal Poverty Guidelines. Before applying for the program, households must first apply for help with the county or state. Discount on medically-needed hospital services available for uninsured households. Households who receive the uninsured discount may also apply for Fairview's Financial Assistance program.

Cash-grant program for adults with low incomes experiencing a household emergency. Adults can receive assistance once every 12 months. The assistance received must resolve the crisis. Adults must use their own money first. The amount of assistance provided might not cover the entire emergency, but it can help. Short-term, one-time grant assistance for persons in a financial crisis because of fire, flood, storm, illness, accident, theft, utility shut-off, eviction, foreclosure, moving expense, necessary home repairs, or need for furniture or appliance replacement or repair.

This is a Medicaid program for beneficiaries who need help in paying for Medicare services. The beneficiary must have Medicare Part A and limited income and resources. For those who qualify, the Medicaid program pays Medicare Part B premiums. Eligibility begins the month of application. Also, if eligible, retroactive coverage for up to three months prior to the month of application. Note: There can be a lag time before SSA is able to stop taking the premiums out of the recipient's benefit check but the recipient will be reimbursed by SSA for all months eligible for SLMB and/or QMB. The reverse is true when these programs terminate: recipients should be told to put aside premium costs from first month of termination on.

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: Contracts with Change Healthcare to assist patients with Minnesota Healthcare Program or Hennepin Healthcare Charity Care applications. 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

• MNsure Enrollment: On the MNsure marketplace, individuals can find, compare, and choose healthcare coverage, including commercial health insurance plans and low-cost or free plans through government programs. A financial counselor can help complete the online application. If eligible for a government program such as Medical Assistance or Minnesota Care, individuals may enroll through MNsure year-round.

Fairview Financial Assistance Program covers charges for most Fairview hospital-based and clinic-based services. Charity Care may be available for households with income at or below 400 percent of the Federal Poverty Guidelines. Before applying for the program, households must first apply for help with the county or state. Discount on medically-needed hospital services available for uninsured households. Households who receive the uninsured discount may also apply for Fairview's Financial Assistance program.

LSCHC may be able to provide assistance for prescription medication

• Free samples are sometimes available, but supplies vary day to day
• Programs to help with certain medications, paperwork, and assistance
• Provide vouchers at the Essentia Health pharmacy to get reduced cost medications

Clients should call for a refill at least 7 days before running out of medicine. Clients who do not will need to pay full cost of the medicine until prescription orders can be refilled.

Mayo Clinic provides support for individuals unable to pay for medically necessary care. This includes:

• Fair and consistent billing and collection practices, including charitable care and financial assistance policies and a standard application process

• Providing extended payment plan options and medically necessary services at reduced rates or at no cost for patients eligible for financial assistance

• Provides emergency care, regardless of ability to pay

This is a Medicaid program for beneficiaries who need help in paying for Medicare Part B premiums. For those who qualify, the Medicaid program pays full Medicare Part B premiums only. Eligibility begins the month of application and, if eligible, retroactively for up to 3 months. Note: There can be a lag time before SSA is able to stop taking the premiums out of the recipient's benefit check but the recipient will be reimbursed by SSA for all months eligible for SLMB and/or QMB or QI. The reverse is true when these programs terminate: recipients should be told to put aside premium costs from first month of termination on.

Offers financial assistance for any emergency and any other medically necessary services provided and billed through the centralized Patient Financial Services. Financial assistance can range from a reduction amount of the balance up to complete forgiveness of the balance outstanding, for patients demonstrating a financial need. Sanford partners with Elevate Patient Financial Solutions to provide financial assistance for uninsured patients who have incurred or will incur medical expenses at Sanford. Elevate provides a patient-focused approach identifying the most appropriate assistance from a variety of resources. Services provided are free.

• Charity Care: Offers financial help to patients who cannot pay all or part of their medical bills. 50-100% of the bill may be paid.

• Pharmacy Assistance Fund: Provides one-time (once a year) prescription assistance to patients experiencing financial hardship. Request must not exceed $500.

• Uninsured Discount: Provides a discount on medically-needed services for uninsured patients

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.

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 help to pay their medical bill

• Elevate Patient Financial Solutions: Help patients without medical insurance find resources to help pay for medical bills

Medicare Savings Programs have four sub-programs: Qualified Disabled and Working Individuals (QDWI): Helps pay for Part A premiums only. Qualifying Individual (QI): Helps pay for Part B premiums only. Specified Low-Income Medicare Beneficiary (SLMB): Helps pay for Part B premiums only. Qualified Medicare Beneficiary (QMB): Helps pay for Part A and B premiums as well as deductibles, coinsurance, and copayments. Monthly income and countable resource limits apply. Countable resources include any checking or savings funds, stocks, and bonds. A home, one car, a burial plot, $1500 in burial expenses (if the amount is set aside), furniture, and other household items are not applied toward the resource limit. Participants pay for Medicare services that aren't covered, such as routine physicals and prescription drugs. Generally under these programs, premiums are put back into the monthly Social Security check, increasing participants' monthly income.

Fairview Financial Assistance Program covers charges for most Fairview hospital-based and clinic-based services. Charity Care may be available for households with income at or below 400 percent of the Federal Poverty Guidelines. Before applying for the program, households must first apply for help with the county or state. Discount on medically-needed hospital services available for uninsured households. Households who receive the uninsured discount may also apply for Fairview's Financial Assistance program.

Provides information about patient's financial responsibility, rates, billing, services provided, and payment options. Services may include:

• Discount rates based on household size and income limits

• Financial Assistance program for the uninsured and underinsured

• Insurance plans accepted and billing information

• Request for an estimate of services

Assists patients in resolving their account balance if they cannot be paid in full.

• Bank Loan: Co-signed by Olmsted Medical Center and provided at 0% interest. Balance owed must be greater than $250. Loan cannot be applied to cosmetic services.

• Extended Payments: Monthly payments based upon the total balance

• Financial Assistance: Offered to individuals who are unable to pay for their medical services. Eligibility is based upon household income and assets as well as the number of people in the household against current guidelines.

MA-QWD is for employed people under age 65 with disabilities who lost their RSDI benefits because their income exceeds Substantial Gainful Activity (SGA) limits. QWD Program pays for Medicare Part A premium if eligible. This is the only benefit provided by QWD.

Contracts with Change Healthcare to assist patients with Minnesota Healthcare Program or Hennepin Healthcare Charity Care applications. Representatives can be accessed at the Clinic & Specialty Center, Whittier Clinic, or Brooklyn Park Clinic. MNsure Enrollment On the MNsure marketplace, individuals can find, compare, and choose healthcare coverage, including commercial health insurance plans and low-cost or free plans through government programs. A financial counselor can help complete the online application. If eligible for a government program such as Medical Assistance or Minnesota Care, individuals may enroll through MNsure year-round. Uncompensated Care Enrollment If not eligible for coverage through MNsure, individuals may qualify for the Uncompensated Care discount program. The program provides discounted care based on family size and annual household income. A financial counselor can answer program questions and help complete the application. Find a list of individual Hennepin Healthcare providers covered by the HHS FAP here. The following list of Clinics/Providers are not covered by the HHS FAP. This list is subject to change. Non-Covered Clinics/Providers

• Associated Nephrology Consultants

• Colon and Rectal Surgery Associates, Ltd.

• University of Minnesota Physicians (pediatric trauma services, neuro-interventional radiologic services)

The Restore a Smile Fund is established to help those in the greater Itasca area who require dental care to help enhance their sense of physical and emotional well-being. Up to $1000, per year if eligible. Donor approval for larger amounts.