SUMMARY OF FINANCIAL ASSISTANCE POLICY
King's Daughters' Health offers emergency and other medically necessary hospital-level services free of charge if you are (1) a permanent resident within the KDH primary service area, which includes the Indiana counties of Jefferson, Jennings, Ripley, Scott, and Switzerland and the Kentucky counties of Carroll and Trimble, (2) and your income is at or below 150% of the Federal Poverty Guidelines (the FPG).
Financial Assistance Program Policy (PDF)
Financial Assistance Program Summary (PDF)
Financial Assistance Application (PDF)
Under our facility's Financial Assistance Policy (FAP), we provide financial assistance for emergency and other medically necessary care on a sliding scale discount from our normal charges if you are a resident within the KDH primary service area, do not have insurance, and your family income qualifies based upon your income and family size.
All applicants will be screened for Medicaid coverage and must cooperate with hospital representatives to be eligible under our Financial Assistance Policy. If you are eligible for financial assistance under our policy, you will receive free or other discounted assistance according to the following sliding scale:
Annual Family Income Amount of Discount
Less than 150% FPG 100%
151% - 175% FPG 80%
176% - 200% FPG 60%
201% - 225% FPG 40%
226% - 250% FPG 20%
Exceptional Medical Circumstances
Even if your family income exceeds 250% of the FPG, if you supply information to support exceptional medical circumstances (for example, terminal illness, excessive medical bills and/or medications, etc.) you may be considered on a case-by-case basis for assistance.
If your insurance does not provide coverage for your services, or if you have exhausted your lifetime maximum insurance benefits, and if you meet the income criteria, you may be eligible for assistance under our Financial Aid Policy.
Charges will not exceed amounts generally billed
If you receive an award of financial assistance under our FAP and your award does not cover 100% of our charges for the service, you will not be charged more for emergency or other medically necessary care than the amount we generally bill patients having insurance.
How to obtain a copy of our Financial Assistance Policy
You may obtain a printed copy of our Financial Aid Policy and the Financial Aid Assistance Form below ...
Financial Aid Policy
Financial Assistance Application Form
You may also access our FAP and Financial Assistance Application Form at these locations ...
King's Daughters' Hospital - 1373 East SR 62, Madison, IN
KDH Business Operations Center - 701 North Broadway, Madison, IN
In addition, if you provide your mailing address to a financial counselor or customer service representative, we will mail you a copy of our Financial Assistance Policy and Application Form. Contact information:
Customer Service - (812) 801-0161
ClaimAid Financial Counselor - (812) 801-0744 | 801-0679 | 801-0451
Request by mail by writing to:
King's Daughters' Health
Attn: Customer Service
P.O. Box 159
Madison, IN 47250
How to obtain information and assistance regarding our Financial Assistance Policy
For information regarding your Financial Assistance Policy and Financial Assistance Application Form, please contact our financial counselors located at any of our locations or by calling any telephone number listed above.
Notes ... This program does not include coverage for independent provider groups not employed by the hospital, such as Cardiologist, Emergency Room Physicians, Nephrology, Neurosurgery, Pain Clinic, and any other physician or advanced practice nurse that my be involved in your care.