Allen County Regional Hospital Financial Assistance
If you need assistance paying your medical bills, we may be able to help. If you qualify for financial assistance, you can get help for your full payment or part of your bill.
Am I eligible for financial assistance?
This is determined on patient, guarantor, and household income criteria defined by federal poverty guidelines. We also consider the balance of your assets such as checking accounts, savings accounts, IRAs, CDs, retirement savings, and investments.
If you qualify for assistance, you will not be billed for more than the amount that a patient with insurance would generally be billed.
What happens if I have a catastrophic medical event?
In situations such as serious medical illnesses or accidents requiring costly treatment, patients who might normally not qualify for financial assistance may be approved for partial assistance.
If you qualify, your responsibility will be whichever is lower:
- 20 percent of your annual income, bank accounts, savings, and investments
- The amount a patient with insurance would generally be billed
When can I apply for assistance?
At any time—before, during, or after you receive care.
How do I apply?
You will need to complete a (free) Statement of Financial Assistance form and provide any requested documentation.
To receive the form:
- Download the form online:
- Call, email, or write the business office
- Visit the admitting office at the hospital
If you have questions while completing the form, please call the hospital’s business office at the number shown below.
What services are included in financial assistance?
Our Financial Assistance Policy covers patient bills for services provided by any of Saint Luke’s hospitals or physician practices.
This policy does not cover physicians, surgeons, anesthesiologists, pathologists, emergency physicians, radiologists, or any other providers who are not employed by Saint Luke’s Health System. View list of covered and non-covered entities (PDF).
For additional information about financial assistance, please contact the business office where you will receive/have received care:
- Hospital Bills: 620-365-1015
- Physician bills: 816-502-7000 or 844-315-5500 (toll-free), Monday - Friday, 8:30 a.m. - 4:30 p.m.
Allen County Regional Hospital
3066 N Kentucky St
Iola, KS 66749
Forms and Policies
Financial Assistance Form
Financial Assistance Policy
Plain Language Summary
- Financial assistance plain language summary (PDF)
- Resumen de la política de asistencia económica en lenguaje sencillo (PDF)