Receiving Hill-Burton
Free or Reduced Cost Care
Frequently Asked QuestionsWhat
services are covered under the Hill-Burton program? Each
facility chooses which services it will provide at no or reduced cost. The covered
services are specified in a notice which is published by the facility and also
in a notice provided to all persons seeking services in the facility. Services
fully covered by a third-party insurance or a government program (e.g., Medicare
and Medicaid) are not eligible for Hill-Burton coverage. However, Hill-Burton
may cover services not covered by the government programs. Private
pharmacy and private physician fees are not covered by this program. However,
services provided by physicians hired by the facility may be covered under the
Hill-Burton program if included in the published notice (Allocation Plan). Can
I receive Hill-Burton assistance to cover my Medicare deductible and coinsurance
amounts or Medicaid co-pay and spenddown amounts? Medicare
deductible and coinsurance amounts are not eligible under the program. However,
Medicaid co-payment amounts are eligible, except in a long-term care facility.
In addition, Medicaid spenddown amounts (the liability a patient must incur before
being eligible for Medicaid) are eligible in all Hill-Burton facilities. Where
can I get Hill-Burton free or reduced cost care?
At a Hill-Burton facility.
Check the Directory
listing. The facilities included are hospitals, nursing homes, clinics,
etc. Apply at the Admissions, Business or Patient Accounts Office.
Who
can receive free care?
Eligibility is based
on a person's family size and income. Income is calculated based on your
actual income for the last 12 months or your last 3 month's income times
4, whichever is less. You may qualify if your income falls within the
poverty guidelines, as published
in the Federal Register every year. You may also qualify for free
or reduced cost care at some facilities if your income is up to double
(or triple for nursing home services) the poverty guidelines.
What
does income include?
Gross income (before
taxes), interest/dividends earned, and child support payments are examples
of income. Assets, food stamps, gifts, loans or one-time insurance
payments are examples of items not included as income when considering
eligibility. For self-employed people, income is determined after deductions
for business expenses. For more specific information, see the poverty
guidelines.
When
can I apply for Hill-Burton assistance? You
may apply for Hill-Burton assistance at any time, before or after you receive
care. You may even apply after a bill has been sent to a collection agency. If
a hospital obtains a court judgment before you applied for Hill-Burton assistance,
the solution must be worked out within the judicial system. However, if you applied
for Hill-Burton before a judgment was rendered and are found eligible, you will
receive Hill-Burton even if a judgment was rendered while you were waiting for
a response to your application. Is
United States citizenship required for Hill-Burton eligibility?
No. However, in order for
a person to have a Hill-Burton eligibility determination made, he must have lived
in the U. S. for at least 3 months. Can
I apply for Hill-Burton assistance on behalf of an uninsured relative or friend?
Yes. You can apply for Hill-Burton
assistance on behalf of any patient for whom you can provide the information
required to establish eligibility, i.e., you must be able to provide information
regarding the patient's family size and income. Do
I have to wait until I am sick before I can apply for Hill-Burton assistance?
Hill-Burton is not health insurance.
In order to apply for Hill-Burton assistance you must have already received services
or know that you will require a specific service in the near future. What
are some reasons I could be denied Hill-Burton care? The
facility may deny your request if: - for
non-nursing homes, your income is more than the current poverty guidelines, or
more than twice the guidelines if specified in the facility's allocation plan.
For nursing home services, your income is more than the poverty guidelines, or
double or triple the guidelines, if specified in the facility's allocation plan
- the
facility has given out its required amount of free care as specified in its allocation
plan
- the services
you requested or received are not covered in the facility's allocation plan
- the
services you requested or received are to be paid by Medicare/Medicaid, insurance
or other financial assistance program
- the
facility asks you to first apply for Medicaid/Medicare or a financial assistance
program, and you do not cooperate
- you
do not give the facility requested proof of your income, such as a pay stub.
What
can I do if I have a complaint against a Hill-Burton facility? If
you feel you were unfairly denied free care or reduced cost care, a complaint
must be filed in writing to the Central Office.
You must include: 1) the name and address of the person making the complaint;
2) the name and location of the facility; and 3) a statement of the actions that
the complainant considers to violate the requirements of the Hill-Burton program. What
other service obligation does a Hill-Burton facility have? Under
the community service assurance, Hill-Burton facilities are responsible for providing
emergency treatment and for treating all persons residing in the service area,
regardless of race, color, national origin, creed or Medicare or Medicaid status.
This assurance is in effect for the life of the facility. If you feel you were
unfairly denied services or discriminated against you should contact the Office
for Civil Rights (OCR) at 1-800-368-1019. How
do I apply for free care? You
should contact the Admissions, Business or Patient Accounts Office at a Hill-Burton
obligated facility to find out if you qualify for assistance and whether or not
a facility provides the specific services needed. How
can I find out which facilities in my area are Hill-Burton facilities?
Check our Directory
listing for your State. Be aware that although a facility may be listed in the
Directory, you still need to call the facility to be certain that it still has
funds available and that the service you desire would be covered. |
