 | NOTICE OF AVAILABILITY OF FREE CARE
PORTER HOSPITAL, INC., is proud of its not-for-profit mission to provide quality care to all people. If you do not have health insurance
and worry that you may not be able to pay for your care, we may be able to help. Porter Hospital provides services without charge to certain patients based on their income, assets, and needs. This Free Care is limited to charges for medically necessary charges incurred at Porter Hospital. Non-medically necessary charges (tubal reversal, elective abortion, etc.) are not eligible for Free Care.
Free Care services are limited to persons whose family income is not above 200% of the
current Poverty Income Guidelines.
SIZE OF FAMILY | POVERTY GUIDELINE | FREE CARE GUIDELINE | 1 | $10,210 | $20,420 | 2 | $13,690 |
$27,380 | 3 | $17,170 | $34,340 | 4 | $20,650 | $41,300 |
5 | $24,130 | $48,260 | 6 | $27,610 | $55,220 | 7 | $31,090 | $62,180 | 8 | $34,570 | $69,140 |
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Please add $3,480 to the Poverty Guideline for each additional family member
*These figures are the January 2007 Poverty Income Guidelines for all states except Alaska and Hawaii. The Poverty Income Guidelines are revised annually.
If you think you may be eligible for Free Care Services, you may request an application from Kathy Nisun, Patient Account Manager at 388-4705 or Kathy Wright, Assistant Patient Acct. Manager at 388-4729 or write to request an application from Porter Hospital Inc., Business Office, 37 Porter Dr., Middlebury, VT 05753.
Porter Hospital will make a conditional or final determination of your eligibility for Free Care Services as follows: Within 2 working days following a pre-service request; or by the end of the first full billing cycle following a post-service request. Ideally, eligibility will be determined using data for a twelve-month period, but recent changes in financial circumstances will also be taken into consideration. PORTER HOSPITAL, INC.
FREE CARE PROCEDURES
Applicants are requested to complete the following:
- Personal Financial Statement
- Free Care Request and Application
- Provide written proof of total income. Ideally this will be for the past twelve months
(from the date of application back twelve months).
Determined as follows:
1) Applicant must prove through financial disclosure that his/her income and/or money available does not allow payment of medical bills and he or she is not covered by any medical insurance plan.
2) Total income is based on how the applicant files his or her taxes (single, married or head of household).
3) Elective inpatient/outpatient procedures (tubal reversal, elective abortion) are not covered services. Admissions must be medically necessary services, with determination made by Porter Hospital's Utilization Department.
4) Applicants whose income falls within the Free Care Income Guidelines will be eligible.
Once completely documented, the Patient Accounts Manager will review to make a
determination of eligibility or ineligibility. The Manager of Patient Accounts then mails written determination to the applicant.
To the best of our ability, Porter Hospital will work with our patients/consumers to apply all of our financial counseling resources to obtain estimated costs for services to be provided by Porter Hospital or our affiliated practices that have a direct financial relationship to Porter Hospital.
Vermont offers several options to help people get health insurance coverage. These include Medicaid, Dr. Dynasaur, VHAP, Catamount Health, and VHAP-Pharmacy. Together, these programs are called Green Mountain Care. Each program has different eligibilty, but Vermonters with incomes up to 300 % of the federal poverty level can qualify. To learn more about these programs go to www.greenmountaincare.org or call 1-800-250-8427. The state also offers help with prescription drugs through the Attorney General's Prescription Drug Finder.
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