Financial Assistance

If you have trouble paying for your care, we can help. Our Patient Financial Advocacy Program reaches out to patients with payment and financial support options at the time of registration. An advocate can be reached by calling (401) 788-1383.

We provide hospital care without charge to uninsured Rhode Island residents with incomes less than:

Rhode Island Resident

Individuals whose primary residence is within the state of Rhode Island, regardless of citizenship or immigration status. A Rhode Island license or other government-issued cards with an address for verification or a copy of a utility bill will serve as proof of residency.

Family Size

Listing of all dependents. Family members must receive at least 50% of their support from the responsible party to be included in the family size calculation.

Proof of support includes the family member being listed on the prior year's tax return as a dependent, canceled checks, or copies of money orders for support expenses.

A family unit is further defined as a group of two or more persons related by birth, adoption, marriage, or other legal means who either live together or who live apart and are claimed as dependents.

Income

Proof of Income is required. Acceptable proof is all three documents listed below:

• Current Federal Income Tax Return*
• Copies of Current Paychecks - Three consecutive months
• Bank Statements - Three consecutive months

*If you did not file federal income tax, you will need to call the IRS at (800) 829-1040 and request letter #1722, which states you did not file.

Income to Report - Income of all wage earners in the household is to be reported. If you are a dependent who is claimed on another family member's income tax then we require that income to be reported on the application with proof of the reported income.

No Income

The following is required for applicants who state they have no income:

• Letter from unemployment stating that the patient is not eligible to receive benefits or that benefits have been exhausted.
• A letter from a person who supplies food and lodging for applicant. Must state how long the person has provided this, must be signed, dated, and notarized.
• Letter from the applicant explaining their situation, when last employed, why no longer employed, and when they expect to be employed.

Asset Protection Threshold

Asset Protection Threshold is a maximum amount of assets that may be held and still allow the patient/guarantor to be eligible for charity care. The asset protection threshold for 2017 is $9,659.00 for singles and $14,488.00 for family units.

Excluded from assets are primary residence and motor vehicle for personal use.

Eligibility

Charity Care is available to uninsured low-income Rhode Island residents ineligible for state, federal, or employer-sponsored health insurance.

The initial eligibility period is six months. Each patient will have to re-apply at the end of each six-month period for Charity Care.

If there is a change in financial circumstances during the initial or subsequent six-month period, such as income or family status, an updated or new application must be completed.

The Charity Care program shall cover all Inpatient and Outpatient medical services routinely billed by South County Hospital Healthcare System and that are covered under the Rhode Island Medicaid program.

The Charity Care Program does not cover charges incurred by AdaptHealth, Emergency Physicians of New England (TeamHealth), Rhode Island Medical Imaging (RIMI), or any anesthesiology charges.

Patients who falsify the information provided on the Charity Care application will no longer be eligible for the program and will be held responsible for all charges incurred while enrolled in the program retroactively to the first day that charges were incurred under the program.

Completed charity care applications should be submitted to the Patient Financial Advocacy Office at South County Health, 100 Kenyon Avenue, Wakefield, RI 02879. They can also be reached at 401-788-1383.

If you are denied financial aid, you may appeal the decision by contacting a patient financial aid advocate at 401-788-1383. You may also contact the Rhode Island Department of Health Information at 1-800-942-7434.

Our financial aid information is also available in French, Spanish and Italian below.