Financial assistance ay Ascension Wisconsin (Fox Valley)

Need help paying your bill? Let us know. At Ascension Wisconsin sites of care in the Fox Valley, 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 NE Wisconsin – Mercy Campus
• Ascension NE Wisconsin – St. Elizabeth Campus
• Ascension Calumet Hospital

Financial Assistance Policy summary

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• English
• Spanish
• Hmong

Financial Assistance Policy

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• English
• Spanish
• Hmong

Covered providers

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• Hmong

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 are not 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.

Financial Assistance application

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• English
• Spanish
• Hmong

Who Is eligible?
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. Patients who are eligible for financial assistance will not be charged more for eligible care than the amounts generally billed to patients with insurance coverage.

What If I Am Not Eligible?
If you do not qualify for financial assistance under the Financial Assistance Policy, you may qualify for other types of assistance. For more information, please contact Customer Service at Ascension by telephone at 1-877-304-6332.

How Can I Get Help with an Application?
For help with a Financial Assistance Policy application, you may contact Customer Service at 1-877-304-6332.

Billing and Collection Policy

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• Hmong

Amount Generally Billed (AGB) Policy

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Working with local, state and national leaders, we advocate for solutions to cover the uninsured and underinsured. In addition to our Financial Assistance Program, these resources provide helpful information:

• Your Connection to Programs for Health, Nutrition and Child Care
• Government Health Insurance Finder
• "From Coverage to Care: A Roadmap to Better Care and a Healthier You" PDF from the Center for Medicare and Medicaid