Applying for Financial Assistance

How Do I Apply?

You will need to complete an easy Financial Assistance Application and attach documents that prove your income. Each patient requesting financial assistance should complete and submit a separate application. 

In order for your application to be processed upon receipt, please provide the following documents as they are necessary to complete the processing of your application:

• Complete Federal Tax Return (most recent) including all schedules and W-2s.
• Copy of most current two month’s paycheck stubs for each income listed.
• Most current month’s bank statements and/or other income verification.
• Social Security Income verification (if applicable).
• Unemployment verification (if applicable).
• Copy of Medicaid denial (if applicable).

Please understand that we cannot process your application until all supporting documentation is received.

When Should I apply?

You should apply for financial assistance as early as possible during your medical care. However, you may apply at any time before, during, or after your treatment, up to the resolution of your Penn Highlands account. 

You may reapply if your financial situation changes.

How do I know if I'm approved?
You will receive written confirmation in the mail.