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Charity Care

Charity Care is designed to help patients with hospital bills. Eligibility is based upon your income and assets on your day of service. The program does not cover physician fees, or diagnostic fees. Under the Affordable Care Act, many people who previously were ineligible for insurance are now able to afford low or no-cost health coverage. Still, some people are not eligible for the Health Insurance Marketplace. Our Financial Counselors are here to help you. The documents listed below may be requested to complete your Charity Care Application:

  • Pay stubs or letter from employer on letterhead giving a breakdown of your gross salary. (pay stubs for one month, thirteen weeks, or 52 weeks prior to date of service)
  • Social Security Benefit letter (covering date of service)
  • Copy of your checking/savings account statement (covering date of service)
  • Identification
  • Welfare benefit letter (covering date of service)
  • Pension, IRA, Mutual Fund, Stock Documentation (covering date of service)
  • Proof of NJ Residency (prior to date of service)

Be sure you have read the income and asset criteria listed on the application.

To apply for the Charity Care Program, download and complete the following forms:

A complete copy of the St. Francis Medical Center Charity Care Policy is available here. A plain language version of our policy is available here.

Una copia completa del Centro Médico de la Política de Atención de Caridad San Francisco está disponible aquí . Una versión en lenguaje llano de nuestra política está disponible aquí.

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