Financial Assistance Program
Euclid Hospital Financial Assistance Program
In compliance with the Ohio Hospital Care Assurance Program (HCAP), Euclid Hospital offers basic, medically necessary hospital-level services free of charge to Ohio residents whose incomes are at or below the Federal Poverty Income Guideline, and who are not recipients of Medicaid. Current recipients of the Disability Assistance Program also qualify for HCAP assistance.
In addition to the HCAP program, Euclid Hospital provides financial assistance to patients who do not have insurance coverage at family income levels up to four times the Federal Poverty Income Guideline. Euclid Hospital also gives consideration to all patients, whether or not they have insurance and regardless of income level if there are exceptional circumstances. The Euclid Hospital financial assistance program applies to hospital services.
|
Size of
Family Unit
|
(HCAP)
Federal Poverty Income Level
|
Euclid Hospital
Financial Assistance
Income Guidelines*
|
|
1
|
$10,400
|
$41,600
|
|
2
|
$14,000
|
$56,000
|
|
3
|
$17,600
|
$70,400
|
|
4
|
$21,200
|
$84,800
|
|
5
|
$24,800
|
$99,200
|
|
6
|
$28,400
|
$113,600
|
|
7
|
$32,000
|
$128,000
|
|
8**
|
$35,600
|
$142,400
|
* Assistance is provided by Euclid Hospital on a sliding scale based on the listed income levels
(Family income level up to four times Federal Poverty Income Level).
** For each additional person add $3,600
If you received medical services at Euclid Hospital and feel you would qualify to receive these services without cost or at a reduced cost to you please complete this application and return it to:
Cleveland Clinic Health System
Patient Financial Services – Customer Service
6801 Brecksville Rd – RK90 – Suite 20
Independence, OH 44131
If you have any questions or wish to speak with a representative regarding the financial assistance programs at Euclid Hospital, please contact the Patient Financial Services Department at 216.636.8500 or toll free 877.236.2247.
Financial Assistance Application - click here to print and complete a Financial Assistance Application. Return your completed, signed application to the address on the front of the application.