Requesting Financial Assistance

Application Process and Policies

Older man reviewing documents

Our Mission

In accordance with Catholic Health Service’s mission to provide health care and services to those in need, to minimize human suffering, to assist people to wholeness and to nurture an awareness of their relationship with God, it is the policy of Catholic Health Services to offer financial assistance for medical bills to our struggling patients and their families based on the ability to pay. We will make every effort to accommodate financial assistance requests, however, we are limited by our financial resources.

Simple Application Process

  1. Review the Financial Assistance Policy.
  2. Print the Verification Letter.
  3. Complete the Application for Financial Assistance form in English or Spanish.
  4. Fax, mail or deliver to your facility’s Business Office along with supporting documentation requested.
  5. Facility to complete Charity Income Worksheet Form and submit to the Corporate Business Office (CBO).

(Please note that proof of income or other financial support is required to qualify. The provision of inaccurate information or the failure to provide requested supporting documentation will serve to disqualify the applicant from receiving financial assistance.)

The individual facilities that comprise Catholic Health Services and their financial counselors and medical assistance representatives can assist you in identifying assistance programs that may aid patients and their families with payment of their health care charges, rent, and tuition charges.

Eligibility for financial assistance for medical bills is determined by the patient’s/resident’s or his/her guarantor’s ability to pay after all available resources have been utilized and all available assistance programs have been accessed.

The program covers payment for medically necessary care, rents, and tuitions, but does not cover routine co-pays and deductibles for patients/residents having medical coverage unless a hardship/need can be documented. Submission of all income and expenses, including medical expenses, plus assets and liabilities of the patient and or guarantor is required when requesting financial assistance.


Financial assistance for medical bills programs are available for the medically indigent, uninsured, underinsured, or financially needy individuals or families of U.S. citizens and legal U.S. residents.

Emergency Medical Care Policy

Facilities do not have dedicated emergency departments, nor do they have specialized capabilities that would make it appropriate to accept transfers of individuals who need stabilizing treatment for an emergency medical condition. As such, we do not have a Provider list. Facilities follow written emergency medical care policies that address how to appraise emergencies, provide initial treatment and refer or transfer an individual to another facility when appropriate.

Facilities’ medical care policies also prohibit facilities from engaging in actions that discourage individuals from seeking emergency medical care, such as demanding that patients pay before receiving initial treatment of emergency medical care. Copies of emergency medical care policies, which include First Responder, Code Blue, Cardio-Pulmonary Arrest/Resuscitation can be found at

Billing and Collection Policy

The organization has a separate billing and collection policy. The hospital does not engage in extraordinary collection actions against an individual to obtain payment before the hospital facility has made reasonable effort to determine whether the individual is eligible for assistance for the care provided under the Financial Assistance Policy. For a copy, contact the Centralized Business Office at 954-484-1515, extension 5220.

Medicaid Beneficiary

An approved Florida Medicaid beneficiary who receives services in our facilities that are not covered by this program automatically qualifies for financial hardship/charity assistance of non-covered healthcare balances.

Financial Assistance — Examples

Catholic Health Services offers Financial Assistance to those patients and their families who qualify based upon total household annual income and family size according to the most recent Federal Poverty Guidelines (FPG). Here are examples of qualifying households and assistance available:

  • Income below 200% FPG — A family of four with a household income of $60,000 or less is eligible for free medical care, rent/tuition.
  • Income above 200% but below 400% — Under Catholic Health Services’ Financial Assistance Policy, medical bills, rents and tuition and fees are capped at 20% of total household income; therefore, a family of four, making $120,000/year, with a $100,000 bill, should expect to be personally responsible for no more than $20,000 annually.
  • In no event will a patient be charged more than the amount generally billed in accordance with Section 501r(5) which, based on the look-back method, is our net revenue realized as a percent of gross charges (67%) for all payors.
  • Other than the hospital staff, contracted Physiatry physicians provide medically necessary care and are covered by the hospital facility’s Financial Assistance Policy.