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  • Financial assistance
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Financial assistance for CO, MT and WY

Caring for those who can’t afford care is part of our mission, and we offer financial assistance to those who qualify. Eligibility is based on family size and gross annual household income and is available to those whose income falls within 500% of the current Federal Poverty Guidelines (updated annually). Individuals who exceed 500% of the Federal Poverty Guidelines will be reviewed for qualifying for and for medical hardship. Those in need of emergency care will never be denied treatment or care if they do not have insurance or are unable to pay.

The documents below are available in eight languages. They will help you understand the process, file an application and learn about our financial assistance policy.

Hospital Discounts for Uninsured Patients

Uninsured hospital patients who do not qualify for other assistance programs (such as Medicaid) receive an automatic discount on their bill. For more information, contact the hospital where you received care.

For our Colorado residents, you can learn more about Hospital Discounted Care (HDC)

Our financial assistance policy

When those who live in our communities need care, financial concerns should not prevent them from receiving treatment. Intermountain Health is committed to providing medically necessary care by offering financial assistance to individuals that qualify.

Intermountain Health offers financial assistance for patients who receive medical care provided in Intermountain clinics and hospitals. The program is for most medical care that a medical provider decides is needed. Intermountain’s Financial Assistance Program only applies to bills with Intermountain Health hospital, clinics, and some healthcare providers employed by Intermountain. Those in need of emergency care will never be denied treatment or care if they do not have insurance or are unable to pay.

  • Financial Assistance is determined on income and household size.
  • People eligible for financial assistance will not be charged more for emergency or other medically necessary care than the amounts generally billed to insured people.

Amounts Generally Billed (AGB) – The amounts generally billed for emergency or other medically necessary care to individuals who have insurance covering such care. Information regarding AGB percentages and calculations may be obtained in writing and free of charge by sending a request to Peaks_Financialassistanceapps@imail.org or by writing to Financial Assistance, 500 Eldorado Blvd. Suite 4300, Broomfield, CO 80021. AGB is calculated using the “Look Back method” in accordance with 501R federal regulations.

Intermountain Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Call 866-877-4325 for more information.

How do I apply?

Application forms and information are listed below in several languages. If you receive (or plan to receive) medical care in an Intermountain hospital or Intermountain clinic and are interested in payment options, call 866-665-2636. To apply for financial assistance in person, visit your local hospital or clinic where you receive services.

Apply for financial assistance

The information below will help you understand the process, file an application and learn about our financial assistance policy.

To learn more about our financial assistance, start by reading our financial assistance brochure. It will answer many of your questions.

Please fill out the financial assistance form, provide required supplemental information and mail your completed application to:

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

After you submit your completed application, our financial counselors will review your application and contact you if they require additional information or to discuss your options.

Read our full policy about financial assistance.

Para más información sobre nuestra ayuda financiera, comience leyendo nuestro folleto, el cual dará respuesta a muchas de sus preguntas.

Por favor complete el formulario de ayuda financiera, proporcione la información adicional necesaria y envié por correo su solicitud a:

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

Después de completar y enviar su formulario,nuestros asesores financieros revisarán su solicitud y se comunicarán con usted en caso de requerir información adicional o si fuere necesario discutir posibilidades o alternativas.

Lea en su totalidad nuestra política sobre ayuda financiera.

لمعرفة المزيد عن مساعدتنا المالية، إبدأ بقراءة كتيب المساعدة المالية لدينا.سوف تجد كل الأجوبة على معظم الأسئلة لديك.

الرجاء ملئ استمارة المساعدة المالية، وتقديم المعلومات التكميلية المطلوبة وإرسال طلبك المكتمل إلى꞉

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

بعد تقديم طلبك المكتمل,، سيقوم مستشارونا الماليون بمراجعة طلبك والاتصال بك إذا كانوا بحاجة إلى معلومات إضافية أو لمناقشة خياراتك.

إقرأ بوليصتنا الكاملة حول المساعدة المالية.

要了解更多关于我们的财务援助, 请先阅读我们的财务援助手册. 它会回答您的许多问题.

请填写财务援助表,提供必要的补充资料,并将您填妥的申请邮寄至:

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

在您提交已完成的申请后, 我们的财务顾问将审查您的申请,如果他们需要额外的信息或需要讨论您的选择,他们将与您联系.

阅读了解有关我们财务援助的完整政策.

Pour en savoir plus sur notre assistance financière, commencez par lire notre brochure à ce sujet. Vous trouverez la réponse à un bon nombre de vos questions.

Veuillez remplir le formulaire d’assistance financière, fournir les renseignements supplémentaires requis et envoyez votre demande dûment remplie à:

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

Une fois que vous aurez remis votre demande dûment remplie, nos conseillers financiers vont examiner votre demande et ils vous contacteront si un complément d’information est nécessaire ou pour revoir vos options.

Lisez toute notre politique sur l’assistance financière.

재정 보조에 대한 자세한 내용을 아시려면 재정 보조 안내서를 읽어보십시오.. 귀하께서 가지신 많은 궁금증을 풀어 드릴 것입니다.

재정 보조 신청서를 작성하신 후 부수적으로 요구되는 정보를 첨부하여 작성한 신청서를 다음의 주소로 보내 주시기 바랍니다

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

작성된 신청서를 제출하시면 재정, 상담사가 귀하의 신청서를 검토한 후 추가 정보가 필요하거나 선택사항에 대해 논의 필요 시 귀하에게 연락이 갈 것입니다.

재정 보조에 관한 저희의 정책을 자세히 읽어 보시기 바랍니다.

Чтобы больше узнать о предоставляемой нами финансовой помощи, прочтите нашу брошюру о финансовой помощи. В ней вы найдете ответы на многие из ваших вопросов.

Пожалуйста, заполните форму заявления о предоставлении финансовой помощи, приложите к ней требуемые дополнительные сведения и отошлите их по почте по адресу:

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

После получения заполненного вами заявления, наши финансовые консультанты рассмотрят его и свяжутся с вами, если им потребуется дополнительная информация или они захотят предложить вам какие-либо варианты.

Также ознакомьтесь с нашими правилами о предоставлении финансовой помощи. 

Để biết thêm về hỗ trợ tài chính của chúng tôi, bắt đầu bằng cách đọc tập sách hướng dẫn mỏng về hỗ trợ tài chính của chúng tôi. Nó sẽ trả lời nhiều câu hỏi của quí vị.

Vui lòng điền vào mẫu đơn xin hỗ trợ tài chính, cung cấp các thông tin bổ sung được yêu cầu và gửi đơn đã hoàn tất đến:

Financial Assistance
PFS SCL Health
500 Eldorado Blvd., Bldg. 6, Suite 6300
Broomfield, CO 80021

Sau khi nộp đơn đã hoàn tất, các cố vấn tài chính của chúng tôi sẽ xem xét đơn của quí vị và liên hệ với quí vị nếu họ cần thêm thông tin hoặc để thảo luận về các lựa chọn dành cho quí vị.

Đọc toàn bộ chính sách về hỗ trợ tài chính của chúng tôi.

Woman in a blue headband sitting and talking to a doctor who is showing her something on a tablet

Talk to a financial counselor

Do you need help paying your bill? Our financial counselors can see if you qualify for financial assistance or discounts, help you make a payment plan or discuss your other options. We also can help you secure Medicaid, Supplemental Security Income and other benefits if you are eligible

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