Financial Assistance Program

El Dorado County Healthcare

Marshall Medical Center is committed to serving the members of our community. We want to make sure that you are given every opportunity to apply for any financial assistance, including charity care, for which you may be eligible if you do not have insurance coverage.

Eligibility for Charity Care / Discount Payment

You may be eligible for financial assistance if you submit the necessary documentation and either: (1) your family income is below 350% of the current Federal Poverty Guidelines (See 2015 Poverty Guidelines Table below); or (2) your family has high medical costs. You would have high medical costs if your annual out-of-pocket costs exceed 10% of your family gross income and essential living expenses in the prior 12 months. The specific level of assistance you may be eligible for will depend on your particular family income level.

The table below will help you understand where you might fall within the Federal Poverty Guidelines:

2017 Poverty Guidelines for the 48 Contiguous States and the District of Columbia

Persons in family household

Poverty Guidelines

1

$12,060

2

$16,240

3

$20,420

4

$24,600

5

$28,780

6

$32,960

7

$37,140

8

$41,320

For Families / households with more than 8 persons, add $4,180 for each additional person.

2016 Federal Poverty Guidelines link to the U.S. Department of Health & Human Services webpage

How to Apply for Financial Assistance

You can apply in different ways:

  • Download the application from our website.
  • Request a paper application be sent via mail by calling (530) 626-2618.
  • Apply in person at our Billing Office located at 3177 Turner Street, Placerville, CA 95667.

If you need assistance with completing the application, or have any questions about our Financial Assistance Program, please contact our Financial Counselors at (530) 626-2618, or visit our Billing Office located at 3177 Turner Street, Placerville, CA 95667. Spanish-speaking Financial Counselors are also available. Spanish translations of the Financial Assistance Policy and application, the Debt Collection Practices, and this Summary are also available.

How Financial Assistance could Impact Your Bill

If you qualify for Financial Assistance, the expenses related to the services you received could be significantly reduced or eliminated. Also, you will not be charged more than the amount generally billed to individuals with insurance coverage for emergency or other medically necessary services. This program does not apply to professional services you may receive with the exception of emergency medical care provided by the emergency physicians at Marshall Medical Center.

Below are examples of the possible charges associated with an emergency room visit and the potential discounts available to eligible individuals under this program:

Example: Emergency Room Visit

Service

2016 Charge

EMS LEVEL II

$1,119.00

LAB CBC

286.00

LAB VENIPUNCTURE

56.00

LAB COMPLETE METABOLIC PANEL

652.00

TOTAL CHARGES

$2,113.00

Example: Possible discounts (dependent on meeting qualification criteria)

DISCOUNT TYPE

CHARGES

(from example above)

AMOUNT YOU WOULD PAY

(must meet qualifications)

Financial Assistance Level III

$2,113.00

$148.36

Financial Assistance Level II

$2,113.00

74.18

Financial Assistance Level I

$2,113.00

37.09

Complete Charity

$2,113.00

0.00

All discount examples are based on the exact charges listed above. Qualifications under any of these programs require meeting guidelines established for each program.

Collection Practices

If you have qualified for Financial Assistance or have negotiated a payment plan and you are reasonably cooperating with us in settling an outstanding bill, we will not knowingly send or assign your bill to an outside collection agency if we know that doing so may negatively impact your credit.

If you have not yet qualified for Financial Assistance but have an application pending, Marshall Medical Center shall not assign your bill to an outside collection agency until at least 180 days have passed from the date of your first billing statement.