All medically necessary and generally available care is provided at Intermountain Healthcare facilities in a timely manner regardless of ability to pay. Intermountain provides financial assistance to residents of the communities we serve, who are otherwise unable to pay for care. This assistance is available to our insured and uninsured patients based on income and personal circumstances.

Apply for Financial Assistance

To apply for financial assistance, complete the Financial Assistance Application online using the link below.  You may also print the application form, fill it out, and give the form, along with the appropriate documentation, to an Eligibility Counselor at the Intermountain facility where you received, or will receive, care. You may also mail a completed form to the facility where services were, or will be, provided.

For more information about Intermountain's Financial Assistance Program, please call the Financial Assistance Helpline at (801) 442-1128 in Salt Lake City, or toll-free at 1-800-442-1128.

Contact Us

You can get answers to other questions about financial assistance by using our secure online form:

If you prefer, you can also get answers by calling our helpline:

Financial Assistance Helpline
Phone: (801) 442-1128
Toll free: 1-800-442-1128

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