Financial Assistance Program
Our representatives can help determine the need for Medicaid or other financial assistance programs.
Pennsylvania Medicaid
The State of Pennsylvania offers Medicaid, a program for healthcare services for low-income individuals with high medical expenses. Please contact UPMC customer service at 1-800-433-0816 or your local county assistance office for additional information.
Financial Assistance Program
We provide discounted healthcare for patients not eligible for Medicaid coverage and who meet certain income and asset requirements.
Payment Plan Options
For qualified balances, payment plans may be established.
Financial Assistance Program
Download the Financial Assistance Program Application
Overview
UPMC is committed to offering financial assistance to people who need emergency and other medically necessary care and are not able to pay for this care. You may be able to get financial assistance if you are not insured or underinsured and meet the eligibility requirements. You may also be able to receive financial assistance if paying your out-ofpocket expenses is seen as a financial hardship for you.
UPMC strives to make sure that the financial capacity of people who need health care services does not stop them from seeking or getting care. This is a summary of the UPMC Financial Assistance Policy (FAP).
Availability of Financial Assistance
You may be able to get financial assistance if you do not have insurance, are underinsured, or if it would be a financial hardship to pay in full the expected out of pocket expenses for the emergency and other medically necessary care you received at UPMC. Please note that there are certain service exclusions that are not typically eligible for financial assistance, including, but not limited to transplants, cosmetic services, and other services.
Eligibility Requirements
Financial assistance is generally determined based upon need which is decided by a review of household income based on the Federal Poverty Level (FPL) and the amount of patient responsibility. If you and/or the responsible party’s income combined is at or below 250% of the federal poverty guidelines, you will have no financial responsibility for the care given by UPMC. If you fall between 250 and 400%, you may get discounted rates for the care given by the provider. No person eligible for financial assistance under the FAP will be charged more for emergency or other medically necessary care than amounts generally billed to individuals who have insurance covering such care. If you already qualify for certain types of governmental aid we may, in certain cases, presume you are eligible for financial assistance. If you have sufficient insurance coverage or are determined to have enough income available to pay for your care, you may not be eligible for financial assistance. Please read the full policy for a complete explanation and details.
Where to Find Information
There are many ways to find information about the FAP application process, or get copies of the FAP or FAP application form. To apply for financial assistance, you may:
- Download the information online at UPMC.com/PayMyBill and select “Learn more about our financial services.”
- Request the information or assistance in writing by mail or by visiting the Patient Financial Services Center at UPMC Quantum 1 Building, 2 Hot Metal Street, Pittsburgh, PA 15203.
- Request the information or assistance by calling 1-800-371-8359, option #2. Availability of Translations The Financial Assistance policy, application form, and the plain language summary can be offered in English, Spanish, Arabic, French, Italian, Nepali, Russian, Chinese, Large Print, and Braille. UPMC may give you translation aids; translation guides, or provides assistance through use of qualified bilingual interpreter by request. For information about UPMC’s Financial Assistance Program and translation services, please call for a representative at 1-800-371-8359, option #2.
How to Apply
The application process involves filling out the financial assistance form and submitting the form along with the supporting documents to UPMC for processing. You may also apply in person by visiting the Patient Financial Services Center at the address listed below. Financial assistance applications should be sent to the following office: Patient Financial Services Center UPMC Quantum 1 Building 2 Hot Metal Street Pittsburgh, PA 15203 Patients of Kane Community Hospital and UPMC Susquehanna can mail application materials to the appropriate address below: UPMC Kane Community Hospital 4372 Route 6 Kane, PA 16735 814-837-8585 Financial Assistance Office, 1205 Grampian Blvd. Williamsport, PA 17701 1-800-433-0816 or 570-326-8196
Financial Assistance Program Application
UPMC Financial Assistance Process Policy
Billing & Collection Policy
Plain Language Summary
Asistencia financiera de UPMC Información sobre la solicitud
Solicitud de Asistencia Financiera en Español
Siga este enlace para leer esta información en Español
Resumen en lenguaje sencillo de la politica de asistencia financiera
The Financial Assistance documents for the following languages: Arabic, Chinese, French, Italian, Nepali, and Russian as well as large print versions are available at UPMC.com.
UPMC Cole
- Main and hospital bills: 814-274-5500
- Physician office bills: 814-274-5502
- Fax: 814-274-0243
Questions? Call our help line at 1-833-879-5015.
Patient Financial Services submits claims to a patient's insurance and follows up until the claim is resolved. We also serve as a resource for patients, guarantors, insurance companies, etc. Individuals can call or come in to discuss billing issues, insurance payment issues and information, our charity policy for hospital services, or our sliding fee program for physician services.
All applications for sliding fee and/or charity care should be sent to the following address:
UPMC Cole
Customer Service
Patient Financial Services
1001 E. Second St.
Coudersport, PA 16915
Physician office sliding fee information
Sliding Fee Allowance Limits
Sliding Fee Application Form
Financial Assistance Program
When applying for the financial assistance program for hospital-based services, the following requirements are needed to process your application: denial letter from Pennsylvania Medical Assistance, proof of income for the past six months; and pay stubs, bank statements, unemployment and social security statements or records, etc,. along with the completed financial assistance application.
Financial Assistance Policy
Financial Assistance Application
Financial Assistance Income Guidelines