Financial Assistance Policy
Eligible individuals
Are patients receiving urgent or medically necessary care who must submit a Financial Assistance Application (including required documentation), and who are determined eligible for Financial Assistance by Penn Highlands Healthcare.
Eligible services
Are emergent and/or medically necessary healthcare services provided by Penn Highlands Healthcare (PHH), which includes Brookville, Connellsville, Clearfield, DuBois, Elk, Huntingdon, Mon Valley and Tyrone facilities, Penn Highlands Healthcare at Home and the Penn Highlands Physician Network (PHPN).
Plain Language Summary
At Penn Highlands Healthcare, we understand that when individuals come to us for care they could be experiencing something urgent that may be unfamiliar or at times frightening. At those times, concerns especially about having an unplanned medical bill should not stop them from having the necessary care they need. At Penn Highlands Healthcare, we strive to provide quality service and safety to the communities we serve regardless of an individual’s ability to pay. Our Financial Assistance Policy, or FAP, exists to provide eligible individuals partially or fully discounted emergent or medically necessary hospital/physician care. Individuals seeking Financial Assistance must apply for the program, which is summarized below.
How to Apply
Financial Assistance Applications may be obtained and/or submitted as follows:
Download
Financial Assistance Application
DownloadYou may also Pick-up an application at the Business Office of any Penn Highlands Healthcare facility at the addresses listed below. You can request an application to be mailed to you by calling the any of the phone numbers indicated below:
- Penn Highlands Brookville 100 Hospital Road | Brookville, PA 15825 | 814-849-1438
- Penn Highlands Connellsville 401 East Murphy Avenue | Connellsville, PA | 724-626-2224
- Penn Highlands Clearfield 438 Front Street, PO Box 992 | Clearfield, PA 16830 | 814-768-2484
- Penn Highlands DuBois 204 Hospital Avenue, PO Box 447, DuBois, PA 15801 | 814-375-4200
- Penn Highlands Elk 763 Johnsonburg Road | St. Marys, PA 15857 | 814-788-8246
- Penn Highlands Huntingdon 1225 Warm Springs Avenue | Huntingdon, PA 16652 | 814-643-8495
- Penn Highlands Mon Valley 438 Front Street, PO Box 992 | Clearfield, PA 16830 | 814-768-2484
- Penn Highlands Tyrone 187 Hospital Drive | Tyrone, PA 16686 | 814-682-1840 or 814-684-1255 ext . 7096
- Penn Highlands Healthcare at Home 757 Johnsonburg Road, Suite 200, | St Marys, PA 15857 | 800-841-9397
Determination of Financial Assistance Eligibility
Generally, individuals are eligible for financial assistance based upon their income level according to the federal poverty guidelines and their ability to pay.
- Individuals with a family income of 100-200% percent of the federal poverty guidelines or less may be eligible for a discount of 100 percent.
- Individuals with a family income of 201-250 percent of the federal poverty guidelines may be eligible for a discount of 80 percent.
- Individuals with a family income of 251-300 percent of the federal poverty guidelines may be eligible for a discount of 65 percent.
Eligible individuals will not be charged more for emergency or other medically necessary care than Amounts Generally Billed, or AGB, to individuals with insurance.
Financial assistance is not available for individuals who opt out of available insurance coverage, or those who fail to reasonably comply with insurance requirements, such as obtaining authorizations or referrals.