Financial Assistance

Missouri Delta Hospital and Clinics (Rural & Non-Rural Health Clinics)

Plain Language Summary: Missouri Delta Medical Center Charity Care Policy (Financial Assistance)

Overview:
Missouri Delta Medical Center wants to make sure that money is not a barrier to getting needed medical care. If you don’t have insurance, don’t have enough insurance, don’t qualify for government help, or simply can’t afford your medical bills, the hospital may be able to lower or eliminate what you owe.

What This Policy Covers:

• Offer of free or discounted medical care based on your income and financial situation.
• Applies to emergency care and medically necessary services.
• Ensures patients are treated fairly, regardless of age, race, gender, religion, immigration status, or sexual orientation.

Who May Qualify:

You may be eligible if you:

• Are uninsured or underinsured
• Can’t afford your medical bills
• Don’t qualify for Medicare, Medicaid, or other public programs

Your eligibility is based on:

• Family income
• Assets
• Other financial resources
• Household size (based on IRS and Census definitions)

How to Apply:

To apply for financial help, you’ll need to provide:

• Pay stubs
• Tax returns
• Proof of government benefits
• Bank statements
• Other financial documents

Applications are reviewed individually. You’ll hear back within 14 business days once everything is submitted. Approval lasts for 6 months, after which you can reapply.

Questions are to be directed to Patient Financial Services at: 573-258-8591

Other Ways You Might Qualify Automatically ("Presumptive Eligibility"):

Even if you don’t submit an application, the hospital might still offer assistance based on your situation. This can happen if you:

• Are homeless
• Get food stamps, WIC, or other assistance
• Live in subsidized housing

How Much Help You Can Get:

Help is based on your income compared to the Federal Poverty Guidelines (FPG):

1. At or below 100% of FPG → You may qualify for free care.
2. 101% to 200% of FPG:
   1. If you have insurance, you may get an 80% discount on balances owed after your insurance has paid.
   2. If you are uninsured, you may get a 20% discount off the patient balance after the application of the 75% discount on gross charges for uninsured patients.
3. Above 200% of FPG → You may still qualify for a discount, especially if you have a large medical bill (over 10% of your income).

Example: If your family earns $50,000 and your medical bills total $20,000, you might only have to pay $5,000.

How You’ll Be Charged:

• The hospital won’t charge you more than what Medicare would pay.
• If you’re approved for assistance, your bills will reflect your discounted rate — not full prices.

Collections and Billing:

• The hospital won’t send your bill to collections or take legal action without trying to help you first.
• If you qualify for charity care and are working with the hospital in good faith, they may offer payment plans and stop any collection activity.

Legal Compliance:

Missouri Delta will follow all federal, state, and local laws in carrying out this policy.

There are 2 separate policies and application forms. One for HOSPITAL & Non-Rural Health Clinics services and the other for our RURAL HEALTH CLINICS. You may obtain them by stopping by the Financial Counselors Office at 1008 N. Main St., Sikeston, MO, the Missouri Delta clinic you are needing assistance with, or print from the links below.

Charity Care Policy & Application *Applies to the Hospital and all Clinics

Sliding Fee Discount Policy & Application *Applies to the following Rural Health Clinics & the providers listed on each clinic's page: 

Benton Community Care Center

Caruthersville Medical Clinic

Chaffee Medical Clinic

Charleston Community Care Center

Dexter Community Care Center

Express Care

Malden Primary Care

New Madrid Community Care Center

Portageville Community Care Center

Primary Care

Smith Street Clinic

Women's Care Center

Missouri Delta Physician Services provides comprehensive medical care to all patients regardless of their ability to pay. To ensure the care is affordable for all patients, Missouri Delta Physician Services-Rural Health Clinics offer a sliding fee discount for those in need. Any patient, whether insured or uninsured, may apply for the sliding fee discount as outlined by the National Health Service Corp. The sliding fee discount allows a patient to receive discounted medical services based on income and family size only. Missouri Delta Physician Services- Rural Health Clinis will not discriminate on the basis of an individual’s race, color, sex, national origin, disability, religion, age, sexual orientation, or gender identity.

The Sliding Fee Discount will only be made available for Missouri Delta Physician Services- Rural Health Clinic visits. Information and forms can be obtained from the reception desk at any of our rural health clinics or from Patient Financial Services located at Missouri Delta Medical Center.

In order to qualify for the sliding fee discount, patients must complete the sliding fee discount application paperwork and provide the appropriate proof of income. If an application is unable to be  processed due to the need for additional information, the applicant has two weeks from the date of notification to supply the necessary information without having the date on their application adjusted.  If a patient does not provide the requested information within the two-week time period, his/her application will be re-dated to the date on which he/she supplies the requested information.  Any accounts turned over for collection as a result of the patient’s delay in providing the information will not be considered for the Sliding Fee Discount Program.

Acceptable proofs of income are as follows:

The Sliding Fee Discount determination will be provided to the applicant(s) in writing and will include the percentage of Sliding Fee Discount write off, or, if applicable, the reason for denial. If the application is approved for less than a 100% discount or denied, the patient and/or responsible party must immediately establish payment arrangements with Missouri Delta Physician Services. Sliding Fee Discount applications cover outstanding patient balances for six months prior to application date and any balances incurred within 12 months after the approved date, unless their financial situation changes significantly. The applicant has the option to reapply after the 12 months have expired or anytime there has been a significant change in family income. When the applicant reapplies, the look back period will be the lesser of six months or the expiration of their last Sliding Fee Discount application.

For more information, please contact Patient Financial Services at 573-258-8591.

Download the Application