Financial Assistance Plain Language Summary

The Financial Assistance Policy, Financial Evaluation Form, and plain language summary are available in Spanish, French and Russian.

Any patient may ask for financial assistance. Anyone else who is responsible for paying for the patient’s care also may ask for financial assistance under the Memorial Healthcare System Financial Assistance Policy.

To learn more about the Financial Assistance Policy, you can:

  • Call the Patient Financial Services Department at 954-276-5501
  • Call the Eligibility Department at 954-276-5760
  • Ask in person at the:
    • Admitting/registration areas of any of the Memorial Healthcare System acute care facilities (located near the main lobby of each facility)
    • Eligibility offices at 2900 Corporate Way, Miramar, Florida
      Staff members are available to discuss and explain the policy Monday through Friday from 8 am – 4:30 pm.

Financial assistance is only available if the patient or responsible party is unable to pay for the patient’s medical care. The ability to pay is determined by using the Federal Poverty Guidelines (FPG). The federal government updates these guidelines annually. The ability to pay is also determined by examining assets. Financial assistance will only be given for medical care that is medically necessary. Elective cases for patients who are not residents of the South Broward Hospital District will be reviewed on a case-by-case basis.

Availability of Financial Assistance

If the patient or responsible party requests financial assistance, Memorial Healthcare System will determine if the patient or responsible party has the ability to pay. This examination, or screening, for financial assistance is free of charge. The amount of the requested financial assistance must be more than $100. Financial assistance is not available when the patient chooses to pay the “self-pay” rate that is available when the payment is made prior to service or discharge.

Patients or responsible parties will be considered for discounts:

  • Up to 100% if the total household income is less than 200% of the FPG
  • Up to 100% if the total balance due is more than 25% of the total household’s annual income
  • Up to 100% if the total household’s annual income is not more than 4 times the FPG for a family of 4
  • From 73% to 90% when the total household’s income is between 201% and 400% of the Federal Poverty Guidelines

Please refer to the full policy (PDF) for a complete explanation and details.

How to Apply for Financial Assistance

If a patient or responsible party would like to apply for financial assistance, please contact Memorial Healthcare System by calling:

  • The Memorial Healthcare System Patient Financial Services Department at 954-276-5501 or
  • The Eligibility Department at 954-276-5760

After contacting Memorial Healthcare System, the patient or responsible party will be given a Financial Evaluation Form and a list of documents to provide to Memorial Healthcare System. This will help determine if the patient meets the requirements for financial assistance.

The patient or responsible party has up to 120 days to provide all of the requested information. Memorial Healthcare System will then review the information and determine whether the patient or responsible party meets the financial assistance guidelines. Memorial Healthcare System will tell the patient or responsible party in writing whether or not they qualify under the Financial Assistance Policy guidelines.

If a patient or responsible party is eligible to receive financial assistance under the Financial Assistance Policy, he or she will not be charged more than the Amounts Generally Billed (AGB). At Memorial Healthcare System, the AGB is determined through the “look-back method” which calculates the average percentage of charges insurance companies pay and applies that percentage to the patient’s accounts. The calculation is available in the Financial Assistance Policy (PDF) or in the Registration areas of any of the facilities.

Please refer to the full policy (PDF) for a complete explanation of the calculation.

Other Languages

The Financial Assistance Policy, Financial Evaluation Form, and this plain language summary are available in several other languages.

Plain Language Summary

Full Policy

Provider Listing