The Fairview Charity Care program covers charges for most Fairview hospital-based and clinic-based services. It does not cover charges for:
Fairview's Charity Care Program does not include care received in free-standing ambulatory service centers. This is covered under Fairview's Charity Care Program. Fairview has a number of financial assistance programs.
If you do not know whether the care you are seeking is covered by Fairview Charity Care, please ask us. If you have questions, call 612-672-6724 or (toll-free) 866-417-3560. Or if you are in the Range/Hibbing area, call 218-362-6624 or toll-free 877-390-6624.
If you qualify for the program, 50 percent up to 100 percent of your bill may be paid depending on your gross annual income, family size and asset guidelines. You must comply with all the terms of the program when you apply, and we also ask you to follow the rules set by your insurance plan.
|Income Limits by Family Size|
|Family size||Annual Gross Income (200% FPL) up to 100% benefit||Annual Gross Income (300% FPL) up to 50% benefit|
If a family has total assets in bank accounts, stock assets, and retirement totaling more than $500,000 they are not eligible for Financial Assistance.
Thank you for your interest in Fairview’s Hospital Charity Care program.
To apply, review the instructions below and complete our Charity Care application form. The application is also available Spanish, Somali, Vietnamese, Hmong, Russian and Karen.
Step 1: Complete and sign this form.
Step 2: Attach these items to the form. We will keep your records confidential (private). Please include records for all adults in your household.
Step 3: Return the form with the above records to the following address:
Patient Financial Services
Attn: Charity Care
1700 University Ave W
St Paul, MN 55104
Step 4: If you have applied for insurance coverage via MNsure or the Affordable Care Act, send the application results.
You will keep receiving bills until we have your complete application. This includes the records listed above. If there are legal fees related to your account, you are not eligible for charity care.
Following a determination of financial aid eligibility, a financial aid-eligible individual will not be charged more than the amount generally billed (AGB) to individuals who have insurance for emergency or medically necessary care.