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Alegent Health Financial Assistance Information

Application for Financial Assistance (PDF)  

Uso para la ayuda Financiera
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As a not-for-profit, faith-based health system, Alegent Health takes pride in providing the highest quality healthcare to all patients and treats everyone with dignity and respect, regardless of their ability to pay.

We are proud to offer a generous financial assistance program, designed to work directly with patients to find payment solutions when necessary. Based on HUD's Geographic Very Low Income Guidelines, financial assistance discounts are determined by a sliding scale of total household income.

Alegent Health's financial assistance programs are available for the medically indigent, uninsured, underinsured, or financially needy individuals or families.

A few examples:

  • Under Alegent Health's Financial Assistance Policy, medical bills are limited to 20% of total household income; for example, a family of four making $55,000/year, with a $200,000 medical bill, would have a final bill of $11,000.
  • Under Alegent Health's Financial Assistance Policy, a family of four with a household income of $32,200 is eligible for free medical care.

The application process is easy. Simply print and complete the Application for Financial Assistance form in  English or in Spanish and fax or mail to the Business Office along with proof of income and/or other financial background information. (Please note that proof of income or other financial support is required to qualify.) A financial counselor will contact you once your information has been received.

Please note: For those who don't qualify based on the current guidelines, other sources of financial assistance may be available, including: extended payment plans and low-interest loans. Please contact the business office to discuss your specific needs. We're here to help.

Alegent Health Business Office
2301 N. 117th Ave.
Suite 100
Omaha, NE 68164
402-717-7878
Toll Free: 888-296-9762
Fax: 402-717-7960
Email:  pacs@alegent.org

 
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Alegent Health is a faith-based, health ministry sponsored by Catholic Health Initiatives and Immanuel Health Systems.
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