Financial Assistance -- Plain Language Summary
It is the policy of Atlantic General Hospital/Health System to provide medically necessary services without charge or at a reduced cost to all eligible persons, who are unable to pay, according to the Hospital's guidelines. Atlantic General Hospital defines all emergency room care as medically necessary even though decisions by insurance companies may be in conflict with this decision.
Financial Assistance (FA) will be available to all patients without discrimination on the grounds of race, color, national origin, age, gender, religion, and creed. A patient must have a valid social security number, valid green card or valid visa in order to be eligible for Financial Assistance. Patients are not eligible for Financial Assistance if the account is for worker's compensation, litigation, or the balance is pending an estate settlement.
An FA eligible individual may not be charged more than the Amounts Generally Billed (AGB) for emergency or other medically necessary care. Eligibility for financial assistance is based on several factors, including income (see Federal Poverty Level guidelines below), household size, assets, and any special consideration that the patient would like to have considered. AGH offers financial assistance to patients who are uninsured and underinsured. Partial or full financial assistance will be granted based on the patient's ability to pay the billed charges. Patients must fully comply with the application process, including submitting tax returns and pay stubs, as well as completing the application process for all available sources of assistance, including Medicaid.
Physician services provided during your stay will be billed separately and are not included on your hospital billing statement.
Am I eligible?
AGH bases Financial Assistance on the patient's income level falling within these ranges:
- 0% to 200% of the Federal poverty guidelines- 100% Financial Assistance.
- Between 200% and 300% of the Federal poverty guidelines- reduced cost medically necessary care at 50% Financial Assistance.
- Below 500% may qualify for financial hardship and receive a 25% adjustment.
If a patient is enrolled in the following programs, their application is deemed eligible for 100% Financial Assistance:
- Reduced/free school lunches
- SNAP (food stamps)
- MEAP (energy assistance)
It is the patient's responsibility to inform the hospital that they are enrolled in a means-tested program and provide documentation. There are other circumstances where Financial Assistance may automatically apply.
Please contact 410-629-6025 for more information.
How can I apply?
The uniform financial assistance application can be found online at: http://www.atlanticgeneral.org/documents/Financial-Assistance-Application2015.pdf
This application can also be obtained at Atlantic General Hospital Registration (9733 Healthway Drive, Berlin, MD 21811) or Patient Accounting Office (10026 Old Ocean City Blvd, Unit 6, Berlin, Maryland 21811)
This form, the FA application and FA policy are available in Spanish.
Where can I find information?
If you have questions or concerns regarding financial assistance, please call 410-629-6025.
You may also visit the Financial Assistance page on the Hospital's website for more information: http://www.atlanticgeneral.org/For-Patients-Visitors/Financial-Assistance.aspx
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