Financial Assistance
ECHN’s Financial Assistance Policy (FAP) exists to provide financial assistance to those who have healthcare needs and are uninsured, underinsured, ineligible for a government program, or are otherwise unable to pay for medically necessary care based on their individual financial situation. Generally, patients may be eligible for financial assistance when their family income is less than or equal to 250% of the Federal Poverty Level (FPL). Additionally, patients may be eligible for partial financial assistance if their family income is greater than 250% but less than or equal to 500% of FPL. level of financial resources.
- Eligible Services
Financial Assistance is only available for emergency or other medically necessary services. Not every service provided within the ECHN hospital facility are covered under the FAP. Certain services that are billed separately by other providers may also not be covered. Please refer to the appendix of ECHN’s FAP for a full list of providers that provide healthcare services within the hospital facility. - Eligible Patients
Patients receiving eligible services, who meet the eligibility criteria and submit a completed financial assistance application. - Uninsured Patients
Patients who have no level of insurance or third party assistance to assist in meeting his or her payment obligations for healthcare services. - Under-Insured Patients
Patients who have some level of insurance or third party assistance but still have out-of-pocket expenses such as high deductible plans that exceed his or her level of financial resources.
Read our complete Financial Assistance Policy and Procedure Guide – English [PDF]
Read our Emergency Department Finanicial Assistance Program Offerings (Excel)
Read our Charity Care Guidelines to see if you are eligible [PDF]
How to Apply for Financial Assistance
The Financial Assistance Application may be obtained, completed and submitted in the following ways:
- Download our Financial Assistance Application
ECHN Financial Assistance Application – English [PDF]
ECHN Financial Assistance Application – Spanish [PDF] - Request a copy be mailed directly to you
Please contact the Financial Counselor’s office
860.646.1222 ext. 2768 - Attain paper copies at various ECHN locations
Copies of the Financial Assistance Application can be found throughout ECHNs facilities. This includes, but is not limited to, our hospital’s Emergency Departments, our Urgent Care Center in South Windsor and patient registration areas. - Schedule an Appointment with the Patient Access Department
Please contact the Financial Counselor’s office
71 Haynes Street
Manchester, CT 06040
Monday – Friday, 9 a.m. – 2 p.m.
860.646.1222 ext. 2768
Financial Counseling
ECHN provides onsite financial counseling to our uninsured and under-insured patients. This includes an explanation of the payment plan options available, the billing process and an assessment of your financial needs. For any questions or to setup an appointment please contact the Financial Counselor’s office at 860.646.1222 ext. 2768.
Facility Billing
It is our responsibility to help you understand the care you will receive and the associated costs of that care. Please be aware that this facility is a hospital-based facility of Eastern Connecticut Health Network (ECHN), which means that the cost for certain services may be higher than those offered at non-hospital-based facilities. Hospital-based facilities charge a facility fee that is separate from, and in addition to, the professional fee charged by the provider. Please note that this charging practice is usual and customary in healthcare, and is not new or unique to ECHN. This notice is being provided to help you understand the existing practice so that you can make informed decisions about your care.
Charges at this facility will include all tests required and ordered by your physician or self-elected screening appointments. Please be advised that depending upon your insurance coverage, you may be personally responsible for all of, or a portion of, the bills for the facility and/or the physician fees. The actual costs will be defined by the services you receive.
If you have any questions about ECHN’s financial assistance policy, procedure, or application guidelines, please call Patient Financial Services at 860.646.1222 ext. 2768.