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Financial Assistance Policy

Financial assistance will be provided for medically necessary health care services -- as determined in conjunction with input from the attending physician taking into account all relevant facts and circumstances -- free of charge to individuals who meet certain financial criteria based upon income, assets and family size.

Financial assistance is the portion of patient care services provided by a facility for which a third-party payer is not responsible and the patient has demonstrated the inability to pay. Financial assistance does not include bad debt or contractual allowances. The term medically necessary is used to define that services are necessary in the continued treatment of the patient’s condition and are emergent.

Please contact us or call one of our financial representatives if you need help to pay your bill. Every effort will be made to ensure that patients with an inability to pay are provided Financial Evaluation Forms and information regarding the financial assistance that is available. Financial Evaluation Forms are to be provided to any responsible party upon request. Patients will be instructed to complete the forms and return them by mail or in person to a Patient Accounts representative. Please contact us or call one of our financial representatives to determine if help is available to you.

Financial Evaluation Forms are to be completed and returned with supporting documentation within 30 days of receipt. Supporting documentation includes verification of income. Verification of income includes:

  • Most recent federal income tax return or Form 1722 from the Internal Revenue Service confirming no tax return was filed
  • Check stubs from the last month or a letter from the employer confirming income

Information on dependents, expenses and assets should also be provided. Lack of supporting documentation or failure to complete all information on the Financial Evaluation Form can result in denial of financial assistance. The Medicaid application or the Medicaid eligibility screening application can be used in lieu of the Hospital Financial Evaluation Form. Documentation exceptions may be made for homeless patients. Information can be independently verified; misrepresentation can result in denial of financial assistance.

If you need help paying for the health services you receive, please contact us or call one of our financial representatives. Financial assistance determination is based upon income, assets and family size using the Department of Health & Human Services Annual Poverty Guidelines published in the Federal Register. Financial assistance is provided for 100 percent of the patient’s responsibility when their income is less than 200 percent of the Annual Poverty Guidelines. A reduced fee schedule is available to those whose income ranges from 200 percent to 400 percent of the Annual Poverty Guideline. Patients’ responsibility may not exceed the Medicare reimbursement amount for a similar service and encounter. Patients’ annual out-of-pocket liability to the Hospital shall not exceed 30 percent of their annual gross income. Patients must be ineligible for coverage by Medicaid to be considered for financial assistance. While the Poverty Guidelines are the primary determinant of eligibility, financial assistance may include evaluation of assets, whether for the wage-earner, small business owner or farmer. Financial Evaluation Forms are active for one year after the approval date and will be applied across all Hospitals during this period.

Reduced Fee Schedule

Federal Poverty Guideline   200%    300%    400% 
Fee Reduction   100%     80%      68%

Financial assistance may be provided for the entire account balance for uninsured patients or for coinsurance, deductibles and non-covered, non-elective services, if the patient meets the eligibility criteria.

Determination of eligibility or denial of financial assistance will be communicated to the responsible party within 30 days of receipt of all required documentation. Services not covered by non-par MC+ plans, out-of-state Medicaid programs and non-covered Medicaid services are also classified as financial assistance. Accounts falling within 90 days of Medicaid eligibility can be considered for financial assistance without completion of a Financial Evaluation Form.

Accounts previously placed with collection agencies will be given consideration for financial assistance.

This Policy addresses only the most common situations that may arise, and it is not intended to be all-inclusive. This Policy is intended to describe the Hospital’s general financial assistance guidelines. If you need help, please contact us or call one of our financial representatives.

Each Hospital’s policy will be widely publicized within their communities, including, but not limited to, posting on each Hospital website; making brochures and posters available at patient registration; reminding patients of the policy with each statement; referencing the availability of financial assistance in BJC’s Community Benefit Report; and informing staff at community health sites such as St. Louis Connect Care, federally qualified health agencies and other social service agencies. All Hospitals will take such further measures to publicize this policy as may be required by applicable law and regulations.

Emergency Care Policy
In addition to the Emergency Department Core Policy in compliance with EMTALA, BJC Hospitals will provide, without discrimination, care for Emergency Medical Conditions (within the meaning of section 1867 of the Social Security Act (42 USC 1395dd)) to all individuals seeking such care regardless of their eligibility under this Financial Assistance Policy.
4901 Forest Park Avenue
St. Louis, Missouri 63108
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