Adena Health System is committed to serving our community, regardless of their ability to pay. That’s why we offer a variety of financial assistance programs to help you get the care you need.
Adena Health System has four programs to help you with the cost of your medical care:
To apply or learn more about these programs, please call Customer Service at 855-275-7408. Besides having a scheduled procedure, documentation is needed before an application can be processed. This includes:
Patients under the age of 18 must be accompanied by a parent or legal guardian when requesting services.
Please note: It could take 60-90 days to receive communication regarding your application.
If you may have difficulty paying for medical care, Adena’s Financial Assistance Program covers people 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 2020 FEDERAL POVERTY GUIDELINES 01/20/2021
Full Write-off HCAP ELIGIBLE FULL Write-off charity 40% Patient responsibility
100% Write off HCAP ELIGIBLE 100% Write-off 60% WRITE OFF
<100% fpl 101-200% FPL 201-400% FPL
| Family members | Annual family income | Annual family income | Annual family income |
| 1 | $0 – $12,880 | $12,881 – $25,760 | $25,761 – $51,520 |
| 2 | $0 – $17,420 | $17,421 – $34,840 | $34,841 – $69,680 |
| 3 | $0 – $21,960 | $21,961 – $43,920 | $43,921 – $87,840 |
| 4 | $0 – $26,500 | $26,501 – $53,000 | $53,001 – $106,000 |
| 5 | $0 – $31,040 | $31,041 – $62,080 | $62,081 – $124,160 |
| 6 | $0 – $35,580 | $35,581 – $71,160 | $71,161 – $142,320 |
| For each additional person, add: | $4,540 | $9,080 | $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 a substantial discounted rate that is adjusted each year. To qualify, you must reside in one of the 15 Ohio counties served by Adena, including:
If you have a financial need, please call Customer Service at 855-275-7408. An Adena representative will guide you through the financial assistance application process. All inquiries are confidential.