Patient Information > Financial Assistance

Culbertson Memorial Hospital is a not for profit entity organized as a hospital district providing services to all persons in its service area regardless of their ability to pay. Any person who feels they are financially unable to pay may apply for financial assistance. Persons meeting the hospital’s financial assistance guidelines will be eligible for free or reduced fees based on the individual’s financial resources.

Eligibility for financial assistance is determined using the Federal Poverty Guidelines (FPG), which are revised and published annually by the Department of Health and Human Services. Persons with a household income at or below the FPG and not eligible for Medicaid will be given care at no charge. Persons with household income above the FPG and not eligible for Medicaid may qualify for discounted care according to the following schedule:

Family Income at or below 125% of the FPG – 80% discount.
Family Income at or below 150% of the FPG – 60% discount.
Family Income at or below 175% of the FPG – 40% discount.
Family Income at or below 200% of the FPG – 20% discount.

Below is the current income guideline as published in the Federal Register on January 24, 2007.

For families with more than eight members, add $3,480 for each additional member.

Persons requesting financial assistance must complete the Application for Credit or Financial Assistance. This application will require you to furnish items such as tax returns, pay stubs or other information to substantiate your family’s income. The application may be obtained by contacting the Patient Accounts Manager at 217-322-4321 extension 254.

Persons who do not make mutually satisfactory payment arrangements for balances due will not be eligible for financial assistance.