Financial Assistance Application

Financial Assistance Information for Knox County Residents

In keeping with our mission to care for all patients, listed below are some guidelines to assist you in understanding available financial assistance options. So that you may be able to receive other medical services such as prescription coverage, as well as services offered beyond Knox Community Hospital, we request persons applying for financial assistance at KCH to apply for Medicaid or other governmental options.

So that we may meet the needs of patients in our community we encourage those who may be eligible for health insurance plans offered through other means to do so. We will schedule procedures for under insured patients or patients receiving partial financial assistance after we receive authorization from their insurance company. Please make arrangements for any expected balance payment amounts before having a procedure.

To accommodate individual needs, if a patient’s medical bills (after insurance payments) are three times their annual salary, their case will be reviewed to provide the best financial assistance option available to them. Financial assistance is only available for medically necessary procedures.

NOTE: Please bring in a current bank statement when filling out/submitting an application for financial assistance.


On January 1, 2014, the Affordable Care Act became law.

What Does This Mean For You?

As of January 1, 2014, when you, the patient, present to a Physician Office and/or Knox Community Hospital for a visit and/or procedure, you will be asked for your insurance information at the time of initial registration. If you indicate that you do not currently have medical insurance, you will be directed to visit www.healthcare.gov, the health insurance marketplace created under the Affordable Care Act.

The Affordable Care Act requires that all Americans apply for health insurance coverage or be subject to a financial penalty. If you choose to pay the penalty rather than apply for health coverage, neither Knox Community Hospital nor it’s medical providers can consider you eligible for financial assistance. When you visit the health insurance marketplace at www.healthcare.gov , you will have the opportunity to apply for a health insurance option that is right for you. It is important to ensure that Knox Community Hospital is a provider for the network plan you select.

In some cases, it may be determined that you, the patient, are eligible for Medicaid Coverage, at which time the site will direct you to benefits.ohio.gov, where you can apply for that assistance. Once you, the patient, have obtained the appropriate health coverage for which you are eligible, you may apply for financial assistance through KCH’s Financial Assistance program to cover any coinsurance amounts and other qualifying expenses (out of pocket expenses other than co-pays).

If you have any questions or need assistance with your health coverage, please contact one of KCH’s Certified Application Specialists, who can help you fulfill these new requirements under the Affordable Care Act, and ensure that you remain eligible for any financial assistance for which you may qualify.

To Contact one of Knox Community Hospital’s Certified Application Specialists, please call a Financial Counselor at 740.393.9631, 740.393.9639 or 740.399.3831.