Lakes Regional Healthcare is committed to providing financial assistance to persons who have healthcare needs and are uninsured, under-insured, ineligible for government programs or otherwise unable to pay for medically necessary care based on their individual financial situation. If you’re unable to pay your bill and meet certain requirements, you may be able to benefit from Lakes Regional Healthcare’s financial assistance policy.
- Financial Assistance Policy (English) (Spanish)
- Financial Assistance Summary (English) (Spanish)
- Financial Assistance Application (English) (Spanish)
How to Request Financial Assistance
Complete the Lakes Regional Healthcare Financial Assistance Application and Consent to Release of Information form.
- Return the application with the most recent copies of your W-2, tax returns, pay stubs and bank statements to the clinic or hospital for review. All information is confidential.
- Your application will be reviewed and a decision will be communicated to you via mail.
Your Eligibility is Determined by:
- Family size
- Income guidelines
- Assets and expenses
If you need further information about financial assistance or assistance with the application process, please call Lakes Regional Healthcare’s Business Office at 712-336-1230.