Hospital Financial Assistance


This policy is effective for hospital discharge dates on or after January 1, 2008.

As a community-based, not-for-profit organization, John C. Lincoln Health Network is committed to serving its community. This service includes providing care to people who cannot afford to pay for it. At the same time, John C. Lincoln has a responsibility to operate in a prudent manner that enables it to continue its services. Therefore, John C. Lincoln seeks to objectively evaluate the circumstances of individual patients and responsible parties and to offer community service in the form of financial assistance where it is needed and appropriate with respect to sound business practices.

John C Lincoln Health Network is committed to providing the best care possible for all of our patients. Our mission is to assist each person entrusted to our care to enjoy the fullest gift of health possible, and to work with others to build a community where a helping hand is available for our most vulnerable members.

John C Lincoln Health Network representatives make every effort to identify patients in need of financial assistance, both at the time of service and through our normal collection process. The information received from patients is obtained with respect to the patient's dignity and privacy.

This policy outlines the process for providing financial assistance to individuals in need of medical care who are not eligible for other assistance programs, for those individuals who are uninsured or underinsured, or for those individuals with a remaining balance after insurance that exceeds their financial means. Patients who choose not to bill their insurance are not eligible for financial assistance.

John C Lincoln Health Network defines uninsured/underinsured patients as follows:

  • Uninsured patient: A patient with no health insurance coverage for inpatient or outpatient services.
  • Underinsured patient: A patient whose health insurance plan does not provide coverage for a specific service or procedure at any hospital or health care facility. This patient is considered to be uninsured for the specific service or procedure.

This policy is for hospital facility charges.


John C. Lincoln Health Network defines financial assistance as charity care.

  • Financial assistance is not available on accounts with a balance less than $25.
  • A Financial Assistance application is only valid for the designated episode of service and follow-up care for that episode.
  • In the event that another person or entity is responsible for the injuries giving rise to this treatment, the hospital retains its lien rights pursuant to A.R.S. 33-931, and will enforce its lien against any such recovery.
  • Documentation is to be maintained in Patient Accounting and available for two years.
  • Financial assistance adjustments may be validated against credit reporting services.
  • Financial assistance may not apply to care received in relation to an injury where another individual or entity is responsible for payment.
  • Financial assistance is not available to patients choosing not to bill their insurance.

A patient or responsible party may be eligible for financial assistance due to hardship and/or compassionate circumstances in addition to Basic Financial Assistance.

  • Basic financial assistance is provided for uninsured patients who sign an attestation indicating that their annual household income is less than 500% of the federal poverty guidelines (FPG) for a family of four. Download the Basic Financial Assistance Uninsured Attestation form. (Requires Acrobat Reader).

    A discount is available if annual income is less than 500% of current-year FPG for a family of four.

    A basic financial assistance adjustment of 75% will be applied to the billed charges.

    This adjustment is consistent with the average payer (insurance) reimbursement for hospital charges.

    The patient or responsible party is eligible to apply for additional assistance due to financial hardship or compassionate circumstances.

  • Financial hardship includes limited income, homelessness, indigence, unemployment, and/or absence of an estate.

    Eligibility for financial hardship is determined by evaluation of a completed application (en español aquí) with appropriate documentation. A patient or responsible party may be approved for financial assistance if he/she meets the income requirements.

    Appropriate documentation may include one of the following forms of documentation: the current year's tax return or W-2, most recent pay stub or unemployment check, Social Security Benefits Statement or Letter.

  • Compassionate circumstances includes the loss of an immediate family member, loss of income due to disability, long-term prognosis with future income diminished, and/or major medical bills.

    Eligibility for compassionate circumstances is determined by a completed application (en español aquí) with appropriate documentation, as well as a letter or other documentation detailing the compassionate circumstances.

    Other mitigating factors may be considered as qualifying for financial assistance.