Adena Health System Financial Assistance Programs
Adena Health System is committed to serving our community, regardless of their ability to pay.
- Application for Financial Aid
- Patient Financial Application Letter
- Self-Employment Verification
- Zero Income Verification
- Financial Assistance Policy
- Plain Language Statement
- Billing and Collection Policy
Adena Health System has four programs to help you with the cost of your medical care:
- Hospital Care Assurance Program (HCAP)
- Community Financial Assistance Program
- Uninsured/Underinsured Patient Discounts
To apply or learn more about these programs, please contact a Financial Counselor at 740-779-8786.
Documentation that is needed before an application can be processed:
- Completed application
- 3 months of income verification prior to date of 1st service on application
- A bank statement that represents the time frame for covered dates
- You must have scheduled procedure.
Some other simple guidelines:
- Patients under the age of 18 must be accompanied by a parent or legal guardian when requesting services.
- If you are having surgery, bring a copy of your living will, power of attorney, and DNR orders.
- If you have a scheduled appointment, please arrive at the time communicated to you by the person who scheduled your appointment.
- Please note: It could take 60-90 days to receive communication regarding your application.
Hours of Operation:
Monday: 8 am to 4 pm
Tuesday: 8 am to 2:30 pm
Wednesday - Friday: 8 am to 4 pm
Locations:Cashiers Office, Adena Medical Office Building4439 State Route 159, Suite 240Chillicothe, OH 45601 Financial Service Building110 Vaughn LaneChillicothe, OH 45601 Adena Cancer Center4435 State Route 159Chillicothe, OH 45601 Adena Fayette Medical Center
1430 Columbus Avenue
Washington Court House, OH 43160
Adena’s Financial Assistance Program Updated to Help More Patients
To help patients who may have difficulty paying for medical care, Adena has updated its financial assistance program, making it more consistent, easier to understand and accessible to more patients. With the new plan, Adena’s Financial Assistance Program covers patients who fall within 400% of the Federal Poverty Guidelines. These are the same guidelines used by the Affordable Care Act insurance exchanges, federally-subsidized programs such as Medicaid, and Ohio’s Hospital Care Assurance Program (HCAP).
|HCAP/CHARITY||scale based on 2021 FEDERAL POVERTY GUIDELINES 01/20/2021|
|Full Write-off HCAP ELIGIBLE||FULL Write-off charity||33% Patient responsibility||33% Patient responsibility|
|100% Write off HCAP ELIGIBLE||100% Write-off||67% WRITE OFF||67% WRITE OFF|
|<100% fpl||101-200% FPL||201-300% FPL||301-400% FPL|
|FAMILY MEMBERS||Annual Family Income from||Annual FamilyIncome to||Annual FamilyIncome From||Annual FamilyIncome to||Annutal family income from||Annual Family Income to||Annutal family income from||Annual Family Income to|
|For each additional person, add||$0||$4,540||$9,080||$13,620||$18,160|
Patients with income at or below 200% of the Federal Poverty Income Guidelines (FPL) are eligible for 100% financial assistance; while those with income between 201% - 400% of the FPL are eligible for an up to 67% discount. To qualify, patients must reside in one of the 15 Ohio counties served by Adena, including: Adams, Athens, Clinton, Fayette, Gallia, Greene, Highland, Hocking, Jackson, Madison, Pickaway, Pike, Ross, Scioto or Vinton (for exceptions please see National Health Service Corporation located in the appendix in the policy).
Looking at the needs of our community played a major role in determining how much financial assistance Adena should provide to patients who may need some help with their medical costs. Patients with a financial need are encouraged to call Adena’s Financial Aid Department at (740) 779-8786 or email FinancialCounselingTeam@adena.org. An Adena representative will guide you through the financial assistance application process, and all inquiries are confidential.