​Phone: (877) 278-6437

             (608) 417- 5035 - specifically for Meriter, but may call the main line as well

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About this resource: UW Health’s Financial Assistance Program helps people who are unable to pay for the medical services they receive. For eligible patients, UW Health may reduce bills in part or in full. This includes any care that was received at UnityPoint Health-Meriter Hospital.

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Who can use this resource? If the household income is at or below 300% of the Federal Poverty Guidelines, you may have no financial responsibility for the care given by UW Health. If your household income falls between 300% and 500%, you may get a discount. Additionally, you qualify for this program if you are not eligible for any county, state, or federal health insurance OR you don’t have the option or ability to purchase health insurance.

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Next Steps:

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• Complete the Financial Assistance Application found here: https://www.uwhealth.org/forms/financial-assistance-program (also available in other languages). Patient must include:

  • The previous year's tax return

  • Pay stubs for the last full month OR a letter stating how you are meeting your daily living expenses if the patient has no income

  • 2 bank statements

  • If applicable, a benefit award letter (pension, unemployment, SSI, SSDI)

 

**NOTE: Navigators can fill out this application on behalf of patients. The Navigator signs on the line stating, “Name of person completing this form if different from patient”. Please include Navigator number. In this case, the patient does not also need to sign.

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If unable to submit the form online, the information may be:

• Emailed to financialassistance@uwhealth.org

• ​​Faxed to 608-833-5039

• Mailed to UW Health Patient Business Services with Attn: Financial Assistance(7974 UW Health Court, Middleton, WI 53562​

• Submitted electronically through your MyChart account​

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