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    CAFFinance
    Medical bills

    Financial Assistance Checklist

    Prepare the documents and questions for hospital charity care or financial assistance.

    Open the tool All tools

    3–5 min

    Typical time to complete

    Patients & caregivers

    Designed for this audience, usable by anyone

    Educational estimate

    Verify final numbers with official records and plan documents

    Medical bills

    Financial Assistance Checklist

    Prepare the documents and questions for hospital charity care or financial assistance.

    Read: Financial Assistance Guide

    Use broad answers only. This tool does not need a hospital name, patient name, exact income, diagnosis, insurance ID, account number, claim number, or medical details. Answers remain in this page's temporary browser state and are not added to My Plan.

    Hospital policies may not include separately billing physicians, laboratories, imaging groups, ambulance services, or other clinicians.

    A pending or rejected claim can make the current balance incomplete.

    Use a broad category. Do not enter an exact income, balance, diagnosis, or account number.

    Do not ignore a written deadline while asking for assistance or clarification.

    Nonprofit hospitals have specific federal financial-assistance policy requirements, but assistance may also exist elsewhere.

    The exact written policy controls household definitions, documentation, covered bills, deadlines, and appeal options.

    Keep proof of requests, submissions, reference numbers, and written decisions.

    Educational only. Community Acquired Finance provides general educational information only. It is not financial, investment, tax, legal, insurance, medical, billing, employment, or benefits advice, and its tools do not make official eligibility, coverage, authorization, tax, billing-liability, or plan determinations. Estimates may be incomplete, outdated, or inapplicable to a specific person, plan, state, employer, provider, or claim. Verify important details with current official sources, controlling documents, government agencies, insurers, employers, billing offices, and qualified professionals.
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