Financial Assistance / Charity Care
Questions?
If you have questions or need assistance completing the application, please contact your hospital or clinic business office.
When Paying Your Bill Is a Concern
Avera has a financial assistance policy (English)(Spanish) if you meet certain requirements and are unable to pay your bill.
How to Request Assistance
- Contact the clinic or hospital business office at the phone number listed on your bill.
- Complete the Avera Financial Assistance Application (English)(Spanish) and the Consent to County Release Form (English)(Spanish).
- Return application with the most recent copies of your W-2, Tax Returns, Pay Stubs and Bank Statements to your clinic or hospital for review.
What to Expect
Your application will be reviewed and a decision will be communicated to you. All information is confidential. Your eligibility is determined by:
- Family Size
- Income Guidelines
- Assets
- Expenses
