To process your application, you must be a registered patient with a Medical Record Number (MRN): For Harborview Medical Center, UW Medical Center-Montlake, UW Medical Center-Northwest, UW Physicians and UW Medicine Primary Care call the Contact Center at 206.520.5000 to register prior to completing your application. Any information submitted for consideration will be treated as protected health information under the Health Insurance Portability and Accountability Act (HIPAA). For all other application submissions continue to submit by mail, fax, or in person. Attach additional information if needed, for example, letters of support to validate your informationįor the Financial Assistance Application and supporting documents in English, you can now utilize M圜hart (except Airlift Northwest) to submit your documents based on your care location.Provide documentation for family income and provide a declaration of assets.Provide your family’s gross monthly income (before taxes and deductions).In order for your application to be processed, you must:Provide us information about your family tell us the number of family members in your household (family includes people related by birth, marriage, or adoption who live together) You can request more information or refer to our website at /financialassistance /financialassistance. Financial assistance may not cover all health care costs,including services provided by other organizations. Such as Endoscopic, Laparoscopic, thyroid, breast & colorectal. Includes sinuses, allergies, snoring, hearing, speech & pediatrics. Working with you to provide the best care for you, delivered the way you want. What does financial assistance cover? The financial assistance policy covers appropriate hospital-based (facility) and non-hospital-based (professional) services provided by UW Medicine depending upon your eligibility. A group of small business owners, not bound by the rules of a large health system. 351% - 400% of the FPL for a 50% financial assistance discount.301% - 350% of the FPL for a 75% financial assistance discount.0% - 300% of the FPL for a 100% financial assistance discountįor facility services only with discharge dates on or after Jat Harborview Medical Center, UW Medical Center, and Valley Medical Center:.For facility and/or professional services at Airlift Northwest, Harborview Medical Center, UW Medical Center, UW Physicians, UW Medicine Primary Care, and Valley Medical Center: UW Medicine provides financial assistance for any patient/guarantor whose gross family income is up to 400% of the Federal Poverty Level (FPL) and adjusted for family size after any third-party coverage has been exhausted. You may qualify for financial assistance based on your family size and income, even if you have health insurance. Washington State requires all hospitals to provide financial assistance to individuals and families who meet certain income requirements.
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