Backus Hospital provides financial assistance programs for certain qualified patients who are unable to pay all or part of their bill for inpatient, outpatient and emergency services rendered at the Hospital.
If you are coping with a financial hardship, and are facing debts owed to Backus Hospital, financial assistance may be available to you.
Backus requests income information from the applicant. Verification of reported income should be included within the application package.
Appropriate verification sources include:
- Most recent Federal tax return and W-2
- Most recent 3 payroll checks
- Copies of unemployment checks
- Copies of any pension, alimony, child support or other sources of income
- Copies of Social Security earnings, if any
- Any other pertinent information
If the applicant has no income a statement detailing the current method of support will be accepted. Proof of income or earnings is required with application or the application will not be considered.
Financial Assistance Options
The level of financial assistance that you may be eligible to receive will be based upon the criteria defined in the Financial Assistance Policy.
The William W. Backus Hospital considers Financial Assistance awards on a case-by-case basis. Please contact us if you have questions regarding eligibility.
Financially Indigent is defined as an individual whose total gross annual income is less than or equal to 250% of the Federal Poverty Guidelines (FPG).
Patients at or below 250% FPG are eligible for a 100% discount off of their outstanding balances. Individuals above 250% up to 400% FPG are eligible for a discount based on their total gross annual income.
Backus Hospital considers an individual to be Medically Indigent if their total annual gross income is above 400% FPG and their outstanding medical obligations are greater than 50% of their total annual gross income.
These individuals may be eligible for a discount separate from traditional financial assistance. Please refer to the Financial Assistance Policy for details regarding eligibility and the discount schedule.
Medically Indigent is defined by the IRS as: “Persons whom the organization has determined are unable to pay some or all of their medical bills because their medical bills exceed a certain percentage of their family or household income or assets (for example, due to catastrophic costs or conditions), even though they have income or assets that otherwise exceed the generally applicable eligibility requirements for free or discounted care under the organization’s financial assistance policy.”
Backus Hospital treats each application individually. If you have any questions about your specific situation, please contact our customer service representatives at 860-889-8331, ext. 2917, Monday through Friday from 7:30 am to 4 pm.