Financial Assistance

If you are unable to pay for services, you may be eligible for assistance. To contact a financial counselor regarding financial assistance for the Hospital please call 419-207-7878. For UH Medical Practices (UHMP) financial assistance please call 216-383-0100.

Click HERE for our Hospital Financial Assistance application PDF. Please follow the below instructions and information.

Please fill out the entire application indicating all of the family members that lived in your household and their relation to the patient on the date of service. Proof of all income received in your home during the 3 months prior to the month of your visit will need to be provided. We have a special form for self-employed patients and patients who claim zero income. You will need to speak to one of our financial counselors prior to mailing your information for screening purposes and to make sure you have all the information we need. To be screened and to request the special forms for the Hospital please call 419-207-7878. For UH Medical Practices, please call 216-383-0100.

Click HERE for our Financial Assistance Plain Language Summary.

Click HERE for our Hospital Billing and Collection Policy.

Click HERE for our Financial Assistance Policy. (Hospital Financial Aid Program)

Click HERE for our Community Benefit Policy.