The Charity Care program covers charges for most Fairview hospitals. You may qualify if your income is at or below 300 percent of the Federal Poverty Guidelines (see chart below).
Before applying for the Charity Care program, you may be asked to first apply for help with the county or state. If you currently have no coverage and are a Minnesota resident, please visit the MNsure website or call 1-855-366-7873. If you are not a Minnesota resident, visit your state's health care reform website. If you have coverage and are not sure if you're eligible for additional coverage through the Affordable Care Act, contact our office at 612-672-6724.
The Fairview Charity Care program covers charges for most Fairview hospital-based and clinic-based services. It does not cover charges for:
Fairview's Charity Care Program does not include care received in free-standing ambulatory service centers. This is covered under Fairview's Charity Care Program. Fairview has a number of financial assistance programs.
If you do not know whether the care you are seeking is covered by Fairview Charity Care, please ask us. If you have questions, call 612-672-6724 or (toll-free) 866-417-3560. Or if you are in the Range/Hibbing area, call 218-362-6624 or toll-free 877-390-6624.
If you qualify for the program, 50 percent up to 100 percent of your bill may be paid depending on your gross annual income, family size and asset guidelines. You must comply with all the terms of the program when you apply, and we also ask you to follow the rules set by your insurance plan.
Income Limits by Family Size | ||
Family size | Annual Gross Income (200% FPL) up to 100% benefit | Annual Gross Income (300% FPL) up to 50% benefit |
1 | $25,520 | $38,280 |
2 | $34,480 | $51,720 |
3 | $43,440 | $65,160 |
4 | $52,400 | $78,600 |
5 | $61,360 | $92,040 |
If a family has total assets in bank accounts or stock assets totaling more than $15,000 they are not eligible for Financial Assistance. If total assets, including retirement, exceed $500,000 they are not eligible for Financial Assistance.
Thank you for your interest in Fairview’s Hospital Charity Care program.
To apply, review the instructions below and complete our Charity Care application form. The application is also available Spanish, Somali, Vietnamese, Hmong, Russian and Karen.
Step 1: Complete and sign this form.
Step 4: If you have applied for insurance coverage via MNsure or the Affordable Care Act, send the application results.
You will keep receiving bills until we have your complete application. This includes the records listed above. If there are legal fees related to your account, you are not eligible for charity care.
The Financial Assistance Policy is available in the following languages: English, Spanish, Somali, Vietnamese, Russian, Hmong and Karen.
The Financial Assistance Plain Language Summary is available in the following languages: English, Spanish, Somali, Vietnamese, Russian, Hmong and Karen.
Fairview has a list of all provider groups that provide emergency and medically necessary services to patients at a Fairview Hospital facility. The list identifies which providers are and are not covered by Fairview’s Financial Assistance Policy.
Fairview Health System Covered Provider List
Fairview Health System Non-Covered Provider List
Following a determination of financial aid eligibility, a financial aid-eligible individual will not be charged more than the amount generally billed (AGB) to individuals who have insurance for emergency or medically necessary care.
English, Amharic, Arabic, Chinese, Hmong, Karen, Oromo, Russian, Somali, Spanish, Vietnamese.
The billing and collections policy is available in the following languages: English, Spanish, Somali, Vietnamese, Russian, Hmong and Karen.