Click here for PLAIN LANGUAGE SUMMARY (PDF)

Capital Medical Center offers financial assistance to insured and uninsured patients who meet certain criteria.  Those patients may be eligible for free or reduced price care.

We request that patients pay out-of-pocket costs, such as deductibles and co-pays, at the time of service. We are happy to work with patients in any way we can to help in understanding charges associated with the care received.

Patients who pay their costs at the time of service are eligible for a prompt pay discount.  If you are unable to pay your costs at the time of service, we are glad to consider you for financial assistance or work out a payment plan for you.

UNDER-INSURED INDIVIDUALS

If you are under-insured, you do have some form of insurance coverage for health care services, but your coverage is insufficient for the care you receive. For example, you are having a baby and your health insurance policy that does not cover maternity benefits.

In this situation, you may be eligible for financial assistance from Capital Medical Center.

UNINSURED INDIVIDUALS

If you are uninsured, you do not have health insurance and are not eligible for Medicare, Medicaid or public assistance.

In this situation, you may be eligible for financial assistance from Capital Medical Center.

VIEW THE CURRENT
FEDERAL POVERTY GUIDELINES »

FINANCIAL ASSISTANCE POLICIES

FINANCIAL ASSISTANCE POLICY (ENGLISH) »
FINANCIAL ASSISTANCE POLICY (SPANISH) »
FINANCIAL ASSISTANCE POLICY (Vietnamese) »
Plain Language Summary of Financial Assistance Policy (English) »
Plain Language Summary of Financial Assistance Policy (Spanish) »
Plain Language Summary of Financial Assistance Policy (Vietnamese) »

APPLYING FOR FINANCIAL ASSISTANCE

You must complete an application to determine your eligibility for receiving financial assistance.

The application requires income verification which includes one (1) document from the following list:

  • Copy of your most recent state or federal income tax return
  • Copy of your pay statements from your employer covering the last two months
  • Written documentation from income sources
  • Copies of all bank statements for the last three months
  • Current credit report (which we can obtain based on your authorization)

In addition, we will verify that you do not have insurance or your insurance does not cover your stay at our hospital.

FINANCIAL ASSISTANCE APPLICATION (ENGLISH) »
FINANCIAL ASSISTANCE APPLICATION (SPANISH) »
FINANCIAL ASSISTANCE APPLICATION (VIETNAMESE) »

FINANCIAL ASSISTANCE DETERMINATION

If you receive financial assistance through our Financial Assistance Program, it may cover 100 percent of your care or only a portion of your care.  If part of the cost of your care remains your responsibility, we will be glad to work with you to establish a monthly payment.

NEED ASSISTANCE?

Our patient financial counselor is available to answer your insurance and other financial questions related to the care you received at Capital Medical Center.

For assistance, please call 360-704-4778 between 9 a.m. and 4 p.m., Monday through Friday, excluding holidays.