Financial Assistance

SEE IF YOU QUALIFY AND APPLY ONLINE

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 Patient Financial Services Department. 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 Patient Financial Services Department or you may download the  healthcare assistance application . Complete and sign the form and return it to our Patient Financial Services Department.

Once a complete application has been received, the Patient Financial Services Director will review the application and in most cases make the eligibility determination within 30-45 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

Plain Language Summary

Financial Assistance Application