Atchison Hospital Guidelines for Financial AssistanceAtchison Hospital provides care to patients in our service area without regard to their ability to pay for the services. Realizing that many in our service area need special consideration in this regard, Atchison Hospital provides a significant amount of services at no charge or a reduced cost to eligible persons who cannot pay for care. Discounts for qualified patients are based on a percentage of the Federal Poverty Guidelines.
These guidelines are updated annually.
Atchison Hospital provides, without discrimination, care for emergency medical conditions regardless of whether the patient is eligible for financial assistance.
Persons and services NOT eligible:
Non U.S. citizens, lacking immigrant status (including visitors and students).
Persons who reside outside of Atchison Hospital service area at the time of service based on location.
Elective/non-emergent procedures including but not limited to: cosmetic type of services, fertility and infertility treatment and procedures including birth control, circumcision, hearing aids and evaluations, weight loss programs unless diabetes related, sports physicals, and Lap Band procedures.
Persons not cooperating to obtain eligibility or payment assistance from third party resources. Collection agency accounts that have incurred legal fees.
Eligibility Guidelines:Eligibility is based on residency, gross income and household size. The discount is given only after all payment sources have been exhausted.
Residency: Applicant must be a permanent resident of our service area as defined below. A post office box is not acceptable. A utility bill or another form of mail addressed to the applicant at the permanent residence will be required.
Kansas primary service area: Atchison, Bendena, Cummings, Denton, Easton, Effingham, Everest, Lancaster, Muscotah, Nortonville, Potter, Troy and Valley Falls. Missouri primary service area: Rushville.
If a person is an immigrant, applicant must have an "Alien Resident Card" or a "United States Citizen Identification Card", not a temporary card or pending status.
Income: All applicants will be asked to disclose and document all sources of income received by the household. Patient or family must have written verification of household income for three or twelve months.
Definition of Income: Income is the total annual cash receipts before taxes from all sources, for all persons in the family unit, with the exceptions noted. Income data for a part of a year may be annualized in order to determine eligibility. Income includes money, wages (including overtime), and salaries before any deductions. Income also includes gross receipts from non-farm or farm self-employment. Income includes (but not limited to) regular payment from social security, railroad retirement, unemployment compensation, strike benefits from union funds, workers' compensation, veterans' payments and public assistance.
Supplemental Security Income, General Assistance or General Relief money payments, training stipends, alimony, child support and military family allotments or other regular support from an absent family member or someone not living in the household; private pensions, stocks, bonds, government employee pension (including military retirement pay) and regular insurance or annuity payments; college or university scholarships, grants, fellowships, and assistantships; and dividend, interest, net rural income, net royalties, receipts from estates or trusts, inheritance and net gambling or lottery winnings.
Household: A household is a group of people who live together. They must be connected by marriage, civil partnership, or be a recognized couple (same sex or opposite sex), or they can be related - a child, parent, sister, brother, nephew, niece or in-law for instance - or have another recognized connection such as fostering or adoption. A household is all people living together in one house collectively. The poverty guidelines are applied to the household as a whole and not the individual.
Not all services are provided and billed by Atchison Hospital. Therefore, the patient will need to discuss financial options and payments with those individual companies; including but not limited to physicians, professional radiology, anesthesia and pathology.
Application GuidelinesTo apply for financial assistance the Patient/Guarantor must meet the above guidelines and provide the following information:
1. The application for financial assistance form must be completely filled out with all requested information received. Incomplete applications will be returned.
2. Patient/Guarantor must provide a copy of their current Federal Tax return and proof of income for the most recent past three months. Self-employed individuals must provide all schedules from their tax return.
3. Patient/Guarantor must provide copies of their three most recent bank statements.
4. Applicant must apply for State assistance through the Department of Health and Human Services Medicaid Program. Financial Assistance is available only after all other payment sources have been exhausted.
5. Patient/Guarantor must provide a letter of explanation briefly explaining their situation and why they are applying for financial assistance.
6. Applications for financial assistance must be received within three months after services are received or prior to services being rendered.
To inquire about financial assistance please call Atchison Hospital at (913) 360-5533.
A discount may be given if:
The income for a family of 1 is below $24,120
The income for a family of 2 is below $32,480
The income for a family of 3 is below $40,840
The income for a family of 4 is below $49,200
The income for a family of 5 is below $57,560
The income for a family of 6 is below $65,920
The income for a family of 7 is below $74,280
The income for a family of 8 is below $82,640
The income for a family of 9 is below $91,000
The income for a family of 10 is below $99,360
Thank you for visiting our website. The Atchison Hospital is a critical access hospital that has been serving the citizens of Atchison, Kansas and the surrounding areas for over 100 years. The Atchison Hospital has a verity of professional medical care services including internal medicine, orthopedics, general surgery, sports medicine, home health and hospice, cardiac rehab and physical therapy and many more. Our staff is trained to provide the best health care for our patients. We invite you to use this resource for your healthcare needs and information. Atchison Hospital, the best care, right here.