Union Hospital offers financial assistance based on ability to pay

The Union Hospital Financial Assistance Program

We are committed to providing high-quality, affordable healthcare services to all members of our community. You may be eligible for full or partial financial aid with your bill, including payment for co-pays, co-insurance, and deductibles. Read below to learn how you may qualify.

Discounts Offered

10% Discount for Insured Patients

After insurance pays the hospital, insured patients may take a 10% discount when the entire remaining balance is paid within 30 days of the statement date.

Discounts for Uninsured Patients

Uninsured self-pay patients may receive a discount off their hospital bill. Payment may be made by cash, check, Discover, Mastercard, Visa, and debit cards. Our discounts include:

30% Uninsured Discount

Uninsured self-pay patients may receive a 30% discount off the total charges if they meet eligibility criteria.

Uninsured patients may also receive additional discounts when hospital charges are paid promptly

20% Prompt Pay Discount

Uninsured self-pay patients may receive 20% discount if payment is received before or at the time of service for outpatient scheduled tests or procedures.

15% Prompt Pay Discount

Uninsured self-pay patients may receive a 15% discount off their hospital bill if payment is made within 30 days from the date the hospital bill is received by the patient.

NOTE: Prompt Pay Discounts may be applied in addition to the Uninsured Self-Pay Discount. Prompt Pay Discounts DO NOT APPLY when a sliding fee discount is taken.

Interest-Free Payment Arrangements

Patients with no insurance or large balances after insurance has paid may be eligible for payment arrangements. Payments may extend up to one year and there is a minimum payment amount required. Larger balances will be handled on a per case basis.

Hospital Care Assurance Program

The State of Ohio provides free care services for medically necessary hospital services for patients who:

  • Meet the residency requirement
  • Are not on a Medicaid program
  • Have gross personal or gross family income at or below Federal Poverty Guidelines

Who is Eligible?

You may be eligible if you have difficulty paying for health care services and do not qualify for Medicaid or other government programs. Our billing office can help determine if you qualify.

Do You Qualify For Free Service?

If your family size is: 1 2 3 4 5 6 7 8
To qualify for 100% financial assistance your household income must be: $11,670 $15,730 $19,790 $23,850 $27,910 $31,970 $36,040 $40,090
For families with more than 8 members, add $4,060 for each additional person.
Maximum Household Income
(For 100% Assistance)
1 $11,670
2 $15,730
3 $19,790
4 $23,850
5 $27,910
6 $31,970
7 $36,040
8 $40,090
For families with more than 8 members, add $4,060 for each additional person.

Sliding Fee Scale

Patients without insurance who do not meet criteria for free care may be eligible for a sliding fee discount of their hospital charges. A Hospital Care Assurance Program (HCAP) application and attached documentation will be evaluated for the sliding fee discount. Uninsured self-pay discount may be applied in addition to a sliding fee.

What Does The Financial Assistance Program Cover?

Medically necessary inpatient and outpatient services are covered. In some cases, qualified patients may not have to pay for services. In other cases, patients may be required to pay only a portion of their bill.

How to Apply

A program application must be completed, signed, and submitted along with any required supporting documents. Our staff will help identify all of your options and assist you with completing financial assistance applications that best meet your personal needs.

Click here to download an application for the Hospital Care Assurance Program.

How are Applications Evaluated?

Union Hospital evaluates each applicant on a case-by-case basis. We use a sliding scale based on Federal Poverty Level Guidelines. Union Hospital uses fair and objective criteria to evaluate each applicant. Call us to find out more.

*Applications for financial assistance are kept completely confidential. The information is shared only with those responsible for determining your eligibility

Medicaid Eligibility

Union Hospital partners with a Medicaid Eligibility Company to help patients apply for Medicaid benefits. A short referral form is completed at the hospital or can be sent to your home. A representative from the company will then contact the patient.

Screening Medicare Patients for Medicaid Eligibility

Patients may be contacted by the Medicaid Eligibility Company to evaluate the Medicare patient's need for Medicaid as a second insurance. Patients will receive help in the Medicaid application process.

We're Here to Help

Please let us know how we can assist you with payment of your hospital bill. Contact the Patient Financial Services staff to discuss any of these Financial Assistance Programs.

Call: 330-364-0842 or 330-364-0847.

Appointments with a Financial Assistance Specialist can be made by calling 330-343-3311 ext 2127

Union Hospital • 659 Boulevard • Dover, OH 44622 •
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