Need help paying your bill? Let us know. At Ascension Saint Agnes, we understand that not all patients have insurance or the same financial circumstances. As part of our faith-based mission, we are dedicated to helping the most vulnerable and treating everyone with compassion, dignity and respect. We have a variety of discount programs and payment options, and trained financial counselors who can work with you one-on-one to understand your bill, your insurance coverage and assistance for which you may qualify. Please review our Financial Assistance Policy, linked below.

These financial assistance documents cover services provided at Ascension Saint Agnes Hospital.

Learn more regarding doctor's office billing at Ascension Saint Agnes.

Contact us

For help with a Financial Assistance Policy application, you may contact a Financial Counselor at Saint Agnes Hospital at 667-234-2140.

Financial assistance documents

Who is eligible?

You may be able to get financial assistance. Financial assistance is generally determined by your total household income as compared to the Federal Poverty Level. If your income is less than or equal to 250% of the Federal Poverty Level, you will receive a 100% charity care write-off on the portion of the charges for which you are responsible. If your income is above 250% of the Federal Poverty Level but does not exceed 400% of the Federal Poverty Level, you may receive discounted rates on a sliding scale. If your income is between 400% and 500% of the Federal Poverty Level and you request assistance, a payment plan will be made available to you. Patients who are eligible for financial assistance will not be charged more for eligible care than the lesser of (1) amounts generally billed to patients with insurance coverage, or (2) charges minus the hospital’s mark-up.

Please call 1-667-234-2140 for more information.

You may be eligible for Maryland Medical Assistance. Medical Assistance is a program that will pay for your health coverage. If you wish to apply with the State please call 1-855-642-8572 or apply online at www.marylandhealthconnection.gov or you can call 1-667-234-3314 or 1-667-234-2188 and we can assist. 

What services are covered?

The Financial Assistance Policy applies to emergency and other medically necessary care. These terms are defined in the Financial Assistance Policy. Elective services and physician charges to both hospital inpatients and outpatients are billed separately and are not generally covered by the Financial Assistance Policy.

How can I apply?

To apply for financial assistance, you typically will complete a written application and provide supporting documentation, as described in the Financial Assistance Policy and the Financial Assistance Policy application.

How Can I Get Help With An Application?

For help with a Financial Assistance Policy application, you may contact a Financial Counselor at Saint Agnes Hospital at 667-234-2140.

How can I get more information?

Copies of the Financial Assistance Policy and Financial Assistance Policy application form are available at to the right and at Patient Financial Services Offices at Saint Agnes Hospital. Free copies of the Financial Assistance Policy and Financial Assistance Policy application also can be obtained by mail by calling 667-234-2140. 

What if I am not eligible?

If you do not qualify for financial assistance under the Financial Assistance Policy, you may ask Saint Agnes Hospital to reconsider the denial of free or reduced cost care and you may qualify for other types of assistance including a payment plan. For more information, please contact a Financial Counselor by calling 667-234-2140 or Customer Service at 667-234-2175.

Translations

Translations of the Financial Assistance Policy, Billing and collections policy, Amounts Generally Billed, Financial Assistance Policy application, and Plain Language Summary are available in Arabic, Chinese (Simplified & Traditional), English, French, Gujarati, Italian, Korean, Russian, Spanish, Tagalog, Urdu, and Vietnamese.

Plain Language Summary of Financial Assistance Policy

Financial Assistance Policy and Covered providers

Billing and collections policy

Amounts Generally Billed

Application for assistance