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Financial Assistance

Financial Assistance

Augusta University Health offers a financial assistance programs for patients and families experiencing financial difficulty and are unable to pay their hospital bill.

Financial Assistance

Augusta University Health offers a financial assistance programs for patients and families experiencing financial difficulty and are unable to pay their hospital bill.

Who is Eligible?

Individuals who received medically necessary services at one of Augusta University Health’s locations. Eligibility is based on the U.S. government’s Federal Poverty Guidelines, published annually. Patients and families with annual incomes less than 200% of the federal poverty level may qualify for 100% discounts. Use the table below to determine whether you qualify by matching the number of dependents living in the same household to your total annual income.

Household Size 200% of Federal Poverty Level
1 $24,980
2 $33,820
3 $42,660
4 $51,500
5 $60,340

Apply for Assistance

Which Providers Participate?

  • Most providers participate in the Financial Assistance Policy when services are performed at one of Augusta University Health’s locations.  Please see FAP Provider Listing for a complete list of participating and non-participating providers.

For more information, call 706-721-2961.

Application Information

Please include the following documents with your application:

  • Copy of their most recent completed and signed Federal Income Tax 1040A, 1040EZ, or 1040 with tax schedules
  • Copy of pay stubs for the most recent past three (3) months with year to date totals for all members of the family working.

If the patient (or responsible party) did not file taxes the last year or if the income situation has changed, the patient should provide photocopies of at least one of the following documents to verify total family gross (before deductions) income.

  • Copy or statement showing alimony, child support, rental income, interest, dividends, regular support payments, income from estates or trusts
  • A dated and signed letter from employer on company letterhead stationary stating the amount of gross income per day period and total number of hours worked per pay period
  • Copy of checks or statement showing pensions, Social Security, Veterans Benefits, Public Assistance. *Temporary Assistance Needy Families (TANF) or Social Security Insurance (SSI) income received by any family members are excluded and will not be included in the calculation of total family gross income.
  • Copy of bank statement showing an “electronic deposit” from the federal government of Social Security, Veterans Benefits
  • Statement showing Worker’s Compensation or Unemployment
  • Copy of Food Stamps Summary
  • Letter from Department of Family and Children Services or Social Security Office verifying income

Please promptly return your income verification documentation in order to complete your financial assistance application. If you do not complete the financial assistance process you will be billed for outstanding hospital balances.

Send documents to:
Patient Accounting Department
1120 15 St., HS 1331
Augusta GA 30912.

If you have any questions, please contact our Customer Service Department at 706-721-2961.

 

Financial Assistance Policies

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