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.
No one will be denied access to services due to inability to pay, the there is a discounted/sliding fee schedule available based on family size and income. We do not discriminate based on an individual’s payor source, including Medicare, Medicaid, and Children’s Health Insurance Program (CHIP).
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.