Financial Assistance

Financial Assistance

Are you in need of financial assistance?

Pana Community Hospital is committed to helping our patients who are in need of financial assistance through our Healthcare Assistance Program. This program was established to assist qualified patients with their medical expenses.

 

Qualified patients may apply for Healthcare Assistance by completing the Healthcare Assistance application and returning it to the Business Office. The application will ask for information about your income and ask you to provide certain documentation. Eligibility is determined by reviewing and verifying family size, income, and assets. If you would like additional information about this program, please contact the business office or you may download the  healthcare assistance application . Complete and sign the form and return it to our Business Office.

 

Once a complete application has been received, the Business Office Manager will review the application and in most cases make the eligibility determination within 60 days. The patient or responsible party will be notified of the eligibility determination by letter.


Should the patient or responsible party not agree with the initial eligibility determination, he/she may submit a written request for additional consideration to the Chief Financial Officer, c/o Pana Community Hospital, 101 E. 9th Street, Pana, Illinois 62557.

 

2016 Financial Assistance Policy
Uninsured / Underinsured Discount
Plain Language Summary
Presumptive Eligibilty Screen Form