Financial Assistance

The Madison Regional Health System offers a financial assistance program to those individuals that qualify and are unable to meet their financial obligations for emergent and medically necessary healthcare services.

Individuals needing assistance in filling out the application can talk to any Business Office Staff either in person or by calling 605-256-6551.

Applications will be reviewed and any decision will be communicated to the individual via a written letter.

All information in the application is completely confidential.

For further questions, individuals can contact the Chief Financial Officer at 605-256-6551.

Steps to take:

  • Obtain Application
  • Complete Application
  • Gather Supporting Documentation
  • Submit Application with Supporting Documentation

Eligibility Criteria Examples:

  • Family Size
  • Income
  • Assets
  • Expenses

**Individuals qualifying for financial assistance will not be charged more than the amounts generally billed for emergent and medically necessary healthcare.

Financial Assistance Application (English)

Financial Assistance Application (Spanish)

Summary of Financial Assistance (English)

Summary of Financial Assistance (Spanish)

Financial Assistance Policy

Exhibit A - Provider Listing

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