Salem Memorial Hospital
Financial Assistance Program
What services are covered:-Emergency care (always provided, regardless of ability to pay)
-Medically necessary care (services needed to treat illness or injury)
- Elective or non-medically necessary services are not covered under this program.
How much help patients can get:
Patients may receive free or discounted careDiscounts are based on:
-Income level
-Family size
-Medical expenses
-Patients with very high medical bills compared to income (medically indigent) may qualify even if income is higher.
Patients will never be charged more than what insured patients typically pay (called “Amounts Generally Billed” or AGB).
How to apply:
Patients must:-Fill out a Financial Assistance Application
-Provide financial documents (like tax returns, pay stubs, bank statements)
-Submit the application within 240 days after the first bill
Applications can be started:
-At the hospital (admission/discharge)-After receiving a bill
Important timelines:
-Application period: Up to 240 days after the first bill-If more info is needed, patients have 10–14 days to provide it
-The hospital pauses collections while an application is being reviewed
Billing and Collections:
-The hospital will try to determine if a patient qualifies before taking serious collection actions-Legal collection actions (like lawsuits or wage garnishment) are only used if:
-The patient does not apply, or
-Does not cooperate with the process
How patients learn about this program:
The hospital shares this information by:-Posting it on their website
-Including it on billing statements
-Providing it at registration, discharge, and public areas
-Offering copies for free at the Business Office
Key takeaways:
-Emergency care is always provided, regardless of ability to pay-Financial help is available for those who qualify
-Patients must apply and provide financial information
-Charges are limited so patients don’t pay more than insured individuals
-The hospital makes efforts to help before sending accounts to collections
Need Help or Have Questions?
We’re here for you!Visit: Business Office at Salem Memorial Hospital
Call: 573-729-6626
Website: www.smdh.net
Our Commitment
We are committed to providing compassionate care and helping patients get the care they need—regardless of their ability to pay.This is a summary. Full policy details are available upon request at no cost.