Financial Assistance

Financial assistance is available for patients who receive medically necessary services and meet the eligibility requirements under the policy. If eligible for financial assistance, patients will receive a discount of 100% or free care. The financial assistance program does not cover elective services.

Am I eligible?

To qualify for financial assistance, all of the following conditions must be met:

The patient must be uninsured or, in certain circumstances, have limited insurance coverage.
The patient must be unable to access other programs that would cover medical expenses.
The patient’s annual family income must be no more than 300% of the Federal Poverty Guidelines for the current year.
The patient must not have substantial cash assets.
The patient must not have declined health insurance through an employer.
The patient must not be ineligible for government sponsored coverage because of noncompliance with requirements.
The service must be considered medically necessary (generally defined as urgent or emergent).
The patient must reside within a 25-mile radius of the facility where services are rendered.
The completed application and all supporting documentation must be submitted to the Patient Account Services department, during the applicable time period, for review and approval. Download a list of required supporting documentation in English or Spanish.

How do I apply?

Applications for financial assistance are available in English and Spanish and can be obtained in several ways:

Download it from here. English version | Spanish version
Call Customer Service toll-free at 877-250-9871 and request a copy. One will be mailed at no charge.
Call the toll-free customer service number on the front of your statement and request a copy. One will be mailed at no charge.
Email a request for an application to [email protected].
Visit the facility where the exam was performed and request one.

How will I know if I have been approved?

Once all requested documents are received, the application will be reviewed, and an approval or denial letter will be mailed to the applicant. The application for financial assistance and documentation that goes with it must be updated every six months, or when the patient’s income or other key circumstances change. Each visit within the six-month period is subject to review.

Exclusions

This policy does not apply to services rendered by independent physicians or practitioners that are not employed by Novant Health. This includes, but is not limited to, anesthesiologists, radiologists, and pathologists. No individual who is eligible for financial assistance will be charged more than amounts generally billed for emergency or other medically necessary care to individuals who have insurance covering such care.