Financial Assistance

Hays Medical Center’s Financial Assistance Program has been established to provide financial relief to those who are unable to meet the financial obligations incurred at Hays Medical Center, for health care. It is our policy to provide full or partial financial assistance to patients and guarantors, within the limits of our resources, based on the patient/guarantor’s current financial situation and ability to pay.

Hays Medical Center will proactively seek out applicants who may be in need of financial assistance. Hays Medical Center will post notice of this policy to all patients through its registration, pre-registration, and financial counseling process. This policy will also be posted in prominent areas of the hospital. The financial assistance process will be carried out with respect and with regard for the dignity of the applicant.

Application of the policy will be made regardless of race, color, religion, creed, sex, national origin, age, or disability of such person, or any other classification prohibited by law. Decisions regarding financial assistance will be made considering all available information.

Confidentiality will be maintained. The intent of this policy is to serve as a guideline for determining eligibility for financial assistance.


  • Financial Counselors:
    The Admissions area, at the main campus, is staffed with Financial Counselors who can assist in the financial assistance process.
  • Patient Financial Services Representatives:
    Patient Financial Service Representatives are located in the Post Rock Building at 2507 Canterbury Road, Hays, KS. They can be reached by telephone at 785.623.5100.
  • The Financial Assistance Application, which can be obtained from the Financial Counselors or Patient Financial Services Representatives, must be completed and returned to the Patient Financial Services Department, along with other requested documents, such as a copy of the latest income tax return, bank stubs and payroll stubs. Hays Medical Center reserves the right to check the accuracy of the information submitted. You can also click, download, and print the¬†Financial Assistance Application.
  • Until the application is completed and returned to Hays Medical Center, the account balance will remain the patient’s/guarantor’s responsibility and will be subject to all standard collection procedures. If the application is incomplete, it cannot be considered for approval.
  • Uninsured applicants will also agree to be referred to an outside agency, which will assist them in applying for coverage through available public programs, such as Medicaid and MediKan.
  • Upon receipt of the completed application and supporting documents, the account will be reviewed and the application will be processed in accordance with the eligibility criteria and program administration set forth in this policy.
  • Conditions:
  • The level of assistance to be provided, total or partial, will be determined by an evaluation and analysis of the patient’s income and other income resources. The Federal Poverty Guidelines issued by the Department of Health and Human Services will provide the initial framework to determine an individual’s ability to pay. Other factors to consider include, but are not limited to:
  • —- The situation of working poor families who may have adequate incomes to “get by” on a day-to-day basis, but for whom medical expenses are unaffordable due to minimal discretionary income
  • —- The situation of those with moderate incomes but who incur significant health expenses beyond their insurance coverage or own ability to pay
  • Patient eligibility will be based on the following:
  • Resources from savings and checking accounts, certificates of deposit, stocks, bonds, real estate, etc. have been exhausted
  • All third party resources and non-hospital aid programs have been exhausted (Deductibles and co-insurance are eligible for charity benefits, if financial circumstances warrant)


  • Annual income compared to the Federal Poverty Guidelines (FPG)
    1. 0% to 130 % FPG = 100% discount
    2. 131% to 250% FPG = 50% discount
    3. 251% to 400% FPG = 30% discount
    4. 401% and above = partial
  • Catastrophic Financial Assistance
    If the total account balance is greater than 50% of the annual income, we will review the patient’s discretionary income compared to the outstanding balance. This may result in partial financial assistance in conjunction with a payment plan.


  • The Financial Counselor or Patient Financial Services Representative will evaluate the patient’s financial assistance application and other supporting documents, using the guidelines outlined in the previous sections.
  • If the patient qualifies for, and is approved for, full financial assistance, the balance will be written off.
  • If the patient does not qualify for full financial assistance, the Financial Counselor or Patient Financial Services Representative will negotiate a monthly re-payment plan, generally not to exceed 84 months. Partial financial assistance will be applied to accounts, in conjunction with a payment plan. The amount approved for financial assistance will be written off on a prorated basis, as each payment is made, determined by the number of payments in the payment plan.
  • Default of the Re-payment Agreement may result in the remaining balance plus any previously written-off amounts becoming immediately due and payable.


  • Any new application for financial assistance received within six months of a previously-approved application will be processed with the same level of assistance as the previous application.
  • If the information on the prior application was deemed to qualify the patient for full financial assistance then the subsequent application will also be processed with full financial assistance.
  • If the prior application qualified the patient for partial financial assistance, with a set monthly payment, then the subsequent application will be processed at the same level of assistance, with the length of the re-payment plan being adjusted up to a maximum of seven years from the date the subsequent application is processed.
  • If it is determined, during the course of processing a single application for financial assistance, that the patient, because of his or her condition or diagnosis, is likely to have subsequent accounts, whatever level of assistance is applied to the single account will also be applied to any subsequent accounts, within a year of the date of the first account.
  • A re-evaluation will take place for any new accounts that occur after one year. A new Financial Assistance Application with new supporting documents will be required from the patient