Financial Assistance Policy

Frequently Asked Questions

St. Mary Medical Center is pleased to inform our patients that we offer financial assistance programs. Medically necessary services will be provided without charge or at a reduced rate to eligible individuals who cannot afford to pay for all or part of their care at St. Mary.

Can I qualify for the Financial Assistance Program if I have insurance?

Yes, as long as your household income falls within the Federal Poverty Level (grid on back) guidelines, you may qualify for the program.

What is covered under the Financial AssistanceProgram?

All St Mary Medical Center hospital charges with the exception of cosmetic surgery and services that are not medically necessary.

Note: Cosmetic and not medically necessary services are excluded by the program. These services are priced at a package rate with no additional discounts. Payments for these exceptions are expected at time of service.

If your physician is in a Langhorne Physician Service group, the program can be used for your office visits with the exception of cosmetic related services.

St Clare Pharmacy prescription refills are included in the program.

What are the reasons I can be denied for the Financial Assistance Program?

  • If the annual income for the household size exceeds the Federal Poverty guidelines.
  • If the individual is eligible for the Health Insurance Exchange plan or Medicaid and refuses or is unwilling to apply for these services.
  • If you did not complete the application or did not supply the necessary documents required to process the application.

Do I have to use my insurance card if I am approved for the Financial Assistance program?

Yes. The St Mary Medical Center financial Assistance program is not a substitute for medical health insurance. If an individual currently has health insurance coverage they cannot discontinue their policy.

I have already received my medical bill. Can I still apply for Financial Assistance?

Yes. Patients are strongly urged to apply for financial assistance before they receive care, however, you can apply for assistance even if your bill has been sent to collections.

When will I know if I qualify for Financial Assistance?

The amount of financial assistance will be determined within 10 business days of submitting your completed application with all required documentation. When the review is completed, you will receive a determination letter. All medically necessary and generally available care is provided in a timely manner regardless of ability to pay.

Will I have to pay anything?

If you qualify for partial financial assistance, you will be asked to pay the discounted rate based on current Medicare rates and percentage for which you are approved.

If you qualify for full financial assistance, you will not be asked to pay any amount out of pocket.

Does my Financial Assistance expire? How will I know it is time to reapply?

Yes. Your financial assistance benefit will expire. Your individual financial assistance ID card will indicate the expiration date on the bottom left corner.

One month prior to the expiration date indicated on your ID card, you need to reapply by submitting a new application form and provide all the required documentation indicated on the form. This will allow our Customer Service team to review and prepare your application for approval.

Eligibility Requirements

Family Size / Period / 100% Discount
250% of Federal Poverty Guidelines / 50% Discount
350% of Federal Poverty Guidelines / 25% Discount
400% of Federal Poverty Guidelines
75% Discount
300% of Federal Poverty Guidelines / 2015 Federal Poverty Guideline (FPG)
1 / Annual / $29,425 / $35,310 / $41,195 / $47,080 / $11,770
2 / Annual / $39,825 / $47,790 / $55,755 / $63,720 / $15,930
3 / Annual / $50,225 / $60,270 / $70,315 / $80,360 / $20,090
4 / Annual / $60,625 / $72,750 / $84,875 / $97,000 / $24,250
5 / Annual / $71,025 / $85,230 / $99,435 / $113,640 / $28,410
6 / Annual / $81,425 / $97,710 / $113,995 / $130,280 / $32,570
7 / Annual / $91,825 / $110,190 / $128,555 / $146,920 / $36,730
8 / Annual / $102,225 / $122,670 / $143,115 / $163,560 / $40,890
Each Add'l Person / Annual / $4,160

If I have additional questions, who can I call?

Customer Service colleagues are available to answer any questions from Monday through Friday 8:00 am to 4:00 pm at 215-710-6500.

St. Mary Community Ministries Resources for Uninsured & Underinsured Patients

Mother Bachmann Maternity Center215.245.4334

St. Mary Children’s Health Center215.245.8873

St. Mary Family Resource Center215.245.8563

BCHIP Adult Health Clinic215.633.8652

1Revised 10/2015