Financial Assistance

Lifespan hospitals treat all people who need care regardless of their ability to pay.

The patient financial services department offers financial assistance to patients who meet specific income guidelines. Please note that copies of your tax returns, W-2 forms and other documents are required to apply for financial assistance.

If you are not insured or insured for only part of your expenses, please talk with one of our financial counselors. They can help you establish a payment plan or apply for financial assistance.

Apply for Financial Assistance

Download an application and instructions:

• English (PDF)

• Spanish (PDF)

• Russian (PDF)

• Portuguese (PDF)

• Khmer (PDF)

 If you have any questions, contact one of our financial counselors.