Hospital Care

You may be surprised to learn how many people are eligible for free or reduced-cost hospital care.  In particular, the federally mandated Hospital Care Assurance Program (HCAP) provides a payment to hospitals for uncompensated care to those with federal poverty-level earnings.

Many with earnings well above the poverty level also qualify for help.   This fact sheet from the State of Ohio website will give you a good overview of the program.  Services must be medically necessary and do not include elective procedures.  Past hospital bills may also be covered; if you have questions, you should check with the hospital that rendered your service.

Coverage under this program is limited; it does not include doctor bills, organ transplants, or any other services charged by someone other than the hospital  — whether it be for a surgeon or anesthesiologist or for something extra, such as television in your room.

 

Yet having said that, the coverage is quite extensive as it relates to medically necessary services provided by hospitals.  If in doubt, you should apply for help, as qualified patients may receive:

  •  Blood tests at hospital-owned labs either at main-campus or satellite locations
  • Inpatient care
  • Outpatient procedures
  • Emergency room care
  • X-Rays and other radiology services
  • Services from hospital-employed doctors

In addition to HCAP, not-for-profit hospitals offer discounts or “charity care” to low-income uninsured or under-insured people.  Discounts are often extended to families with income up to 400% of the federal poverty level.  You should ask a financial aid representative at your hospital to find out what’s available and whether you qualify.

If there are no easy rules, it’s because requirements vary from hospital to hospital and from state to state.  Here in Akron, our three major hospitals follow a typical approach.  All three, for example, go beyond minimum requirements.  For example, free hospital care is extended to qualified recipients earning up to 200% of the federal poverty level.   Those who miss the cutoff for free hospital care may still qualify for discounts.

Take Akron General Medical Center as an example.  Based on information on Akron General’s website, and confirmed by a hospital official, if you are in a family of four, with an annual household income of $88,200, you would qualify for a 30 percent discount on medically necessary hospital services, providing you have no health insurance coverage.  How so? Because at that level of income, a family of four would take in four times the amount of the federal poverty level — putting that family’s income at 400% of the federal poverty level.  At Akron General, if you earn more than 100 percent of the poverty level, you must be uninsured to qualify for discounts that extend to people who are above the poverty level.

Typically, no applications are approved until services are rendered.  However, you can call a local hospital and ask for an application.  By speaking with a a financial assistance representative, you should get a good idea of whether you qualify and the extent of the break you’re likely to receive.  The application process starts after a service is rendered, and a hospital representative can help you fill out an application for HCAP if you would like such assistance.  You will need to supply proof of your income.

While your application is pending, your hospital bill will be on hold — meaning you won’t get a bill – until a determination is made on your eligibility and the extent of assistance you will receive .   The process typically takes 5 to 6 weeks.  At Akron General, you need not be a resident of Ohio to qualify. At Summa Health System, you must be an Ohio resident.

At Summa – which includes Akron City, St. Thomas and Cuyahoga Falls General hospitals – discounts also apply to those with incomes of up to 400% of the federal poverty level.

Under Summa’s program, you may earn up to 200% of the federal poverty level — and have health insurance — and still qualify for free hospital care.  If you are uninsured, you are eligible for discounts if you earn up to 400% of the federal poverty level.

Akron Children’s Hospital also offers free care to those in households with earning of 200% of the federal poverty levels, and discounts to those in households with up to 300% of poverty-level earnings.  To qualify for Children’s sliding-fee charity program, you do not have to be uninsured.  You may even receive help with balances after insurance pays.  The one thing uninsured families must do to qualify for sliding fees is apply for Medicaid; the sliding fees will apply only when Medicaid is denied.  Hospital financial aid representatives will help with Medicaid applications and follow up to see if coverage is secured.  Click here to learn more.

Within Summit County, you can call:

330-344-2000 at Akron General

330-543-2455 at Children’s

330- 375-6685 at Summa

Keep in mind, these free and discounted-care programs are for medically necessary services.  If you’re thinking implants or weight reduction surgery, you won’t be covered.

Because healthcare information changes rapidly, you should always verify information with your providers.