Patient Financial Assistance

Get the help you need to pay for your care.

Financial Assistance Program

También están disponibles en español la información sobre el Programa de Ayuda Financiera y la Solicitud de Ayuda Financiera.
Descargar Política de Asistencia Financiera

Descargar la solicitud de asistencia financiera

Credito y Cobranzas

Programa de asistencia financiera Resumen en lenguaje sencillo

What is the Financial Assistance Program?

The Financial Assistance Program helps those who are unable to pay for the cost of their care.

Who can apply?

All patients and responsible parties are eligible to apply for the Financial Assistance Program. The Financial Assistance Program provides discounts to families:

Who are at or below 400% of the Federal Poverty Guideline (FPG) or who have balances billed by St. Charles that total more than their family’s annual income

No individual Financial Assistance Program eligible person will be charged more for emergency or medically necessary care than the amount generally billed.

NOTE: All insurance opportunities and/or reimbursements must be exhausted before a financial discount is applied

Which providers participate in the St. Charles Financial Assistance Program?

Download the list of providers (updated Nov. 8, 2021)

How do I get a financial assistance application?

The St. Charles Health System Financial Assistance Program application and policy are available free of charge by:

Download and print the application here
Pick up from a financial counselor at a location listed below
Call to request one be mailed

How do I submit my financial assistance application?

You can submit the St. Charles Health System Financial Assistance Program application by:

Fax the completed application to this number: 541-706-6707
Drop off completed application at any Financial Counseling location, listed below
Mail the completed application to this address:

St. Charles Health System
Attn: Financial Assistance
PO Box 6095
Bend, OR 97708

General Income Guideline (based on 400% of the 2021 FPG)

Family size	Annual income
1	$51,520 or less
2	$69,680 or less
3	$87,840 or less
4	$106,000 or less
5	$124,160 or less
6	$142,320 or less
7	$160,480 or less
8	$178,640 or less
NOTE: For families with more than 8 persons, add $18,160 for each additional person.