Do You Need Health Care but Have No Medical Insurance?

Lehigh Valley Hospital cares for all people, regardless of their ability to pay

Application for Reduced Cost of Care

Click here to print your form (English)
Click here to print your form (Spanish)

Nearly 46 million Americans, including more than 8 million children, are living without health insurance. At Lehigh Valley Hospital and Health Network (LVHHN), we’ve made a promise to care for all patients regardless of their ability to pay. It’s so important to us, it’s stated in our mission and values statements.

In each of the last four years, LVHHN has provided more than $4.8 million in free care to the community. If you have no health insurance, or if your insurance plan only partially covers your medical expenses, our program can help. We’re the only local hospital to offer a reduced-cost program to families with a household income four times greater than federal poverty guidelines.

If You Have No Insurance

Let’s say, for example, you slipped on the ice and injured your ankle. You think it might be broken. At LVHHN’s emergency department, all you have to do is tell the receptionist you don’t have health insurance. You’ll receive the same high quality of care all our patients receive.

After your treatment, you’ll be asked to schedule an appointment with one of our six financial counselors. First, your counselor will help you apply for medical assistance from the state. If you don’t qualify, your counselor will help you fill out the necessary paperwork for our reduced cost of care program. You’ll be asked to provide proof of your household income and the number of people living in your household. The amount your bill will be reduced depends on where you fall within the following scale.

Lehigh Valley Hospital and Lehigh Valley Hospital-Muhlenberg

Patient Responsibility Policy

Payment Forgiveness Guidelines

Effective April 2007

Annual Income Levels

(A) No payment required if Annual Income is 200% or less of the Federal Poverty Guideline.

Examples:

1. Billed charges $1,000 and income less than 200% of Federal Poverty Guideline
   $1,000 X 100% = $0 payment
2. Billed charges $1,000 and income at 200% of Federal Poverty Guideline
   $1,000 X 8.75% = $87.50 payment
3. Billed charges $1,000 and income at 300% of Federal Poverty Guideline
   $1,000 X 17.5% = $175.00 payment
4. Billed charges $1,000 and income greater than 400% of Federal Poverty Guideline
   $1,000 X 35% = $350.00 payment

If You Are Under-insured

Let’s say, for example, your ankle is severely broken and surgery is needed to repair the damaged bone. You have insurance but your plan will only pay a portion of your medical expenses. Again, all you have to do is tell us your insurance may not cover the procedure and we’ll put you in touch with a financial counselor.

The amount not covered by your insurance company is your responsibility. But by applying for our reduced cost of care program, the amount you owe may be drastically reduced or totally eliminated, depending on where you fall in the above scale.

Reduced Cost of Care Application

To print an application for our reduced cost of care program, click here. If you are uninsured or under-insured and receiving medical bills from LVHHN you can’t afford to pay, complete and mail the form to the address listed. If you have a meeting scheduled with a financial counselor, you can save time by printing and completing the form at home and bringing it with you to your meeting.

Payment Options

If you’ve applied for assistance but still have a balance you are responsible to pay, a payment plan can be established. Such plans are interest free and may be extended up to eighteen months.

Unpaid balances, including all applicable co-payments, co-insurance, deductibles and any non-covered services must be paid within 30 days of receipt of the statement. Payments may be made via:

• Cash, check or money order
• Visa
• MasterCard
• Discover
• American Express

For your convenience, walk-in customer service is available at four locations:

LVH-Cedar Crest Cashier’s Office

Location:Just off the Pool Pavilion’s main lobby to the left of the elevators.
Walk-in Hours: Monday through Friday, 8 a.m.-4:30 p.m.

LVH-17^th and Chew Cashier’s Office

Location: 2^nd floor
Walk-in Hours: Monday through Friday, 8 a.m.-4:30 p.m.

LVH-Muhlenberg Cashier’s Office

Location: 2^nd floor
Walk-in Hours: Monday through Friday, 8 a.m.-4:30 p.m.

LVHHN Patient Accounting Department

Location:
Lehigh Valley Hospital and Health Network
1249 S. Cedar Crest Blvd.
Allentown, Pa. 18103
Walk-in Hours: Monday through Friday, 7:30 a.m.-4:30 p.m.
Phone Numbers: 610-402-3025 or 1-800-608-6800

Patient Billing Customer Service E-mail Address
patient.billing@lvh.com

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