Financial Assistance Application | Provider Listing | Federal Poverty Income Guidelines
Western Reserve Hospital is committed to providing financial assistance responsive to the needs of the community, regardless of race, age, gender, color, ethnic background, national origin, citizenship, primary language, religion, disability, handicap, education, employment or student status, disposition, relationship, insurance coverage, community standing, or any other discriminatory differentiating factor.
Healthcare Financial Assistance (“HFA”) is a program that is fully funded by Western Reserve Hospital. It covers patients without health insurance and those with only partial insurance coverage (i.e. the uninsured and underinsured) who meet the income and other eligibility criteria described herein.
Western Reserve Hospital offers other options for uninsured or underinsured patients who do not qualify for financial assistance under this HFA policy. For further information, please see the following Western Reserve Hospital policies:
Western Reserve Hospital provides care, without discrimination, for emergency medical conditions to all individuals regardless of whether they can pay or are eligible for assistance under this HFA policy. Western Reserve Hospital will not engage in actions that discourage individuals from seeking emergency medical care, such as by demanding that emergency department patients pay before receiving treatment for emergency medical conditions or by permitting debt collection activities that interfere with the provision of emergency medical care. Emergency medical services, including emergency transfers, pursuant to the Federal Emergency Medical Treatment and Labor Act are provided to all Western Reserve Hospital patients in a non-discriminatory manner.
This HFA policy applies to all emergency and other medically necessary care provided by the Western Reserve Hospital, as well as certain other providers delivering emergency or other medically necessary care in Western Reserve Hospital’s facilities. Attached is a list of providers, other than the Western Reserve Hospital, delivering such care in Western Reserve Hospital facilities, that specifies which providers are covered by this HFA policy and which are not covered.
The following services are not covered under this HFA policy:
Health Savings Accounts
Federal Poverty Guidelines
Health Insurance Marketplace (Exchange) Participation
Accuracy of Application
Following a determination of eligibility under this policy, a patient eligible for financial assistance will not be charged more for emergency or other medically necessary care than the amount generally billed (AGB). At least annually, Western Reserve Hospital calculates an AGB percentage based on the Look-back Method (as defined by Treasury Regulations under section 501(r) of the Internal Revenue Code of 1986, as amended). Members of the public may obtain the current AGB percentage for any Western Reserve Hospital (and a description of the calculation) in writing and free of charge by contacting Western Reserve Hospital as indicated on Page 5.
Financial counselors are available to answer your questions about payment arrangements, insurance coverage, Medicare and other financial inquiries.
For more information about financial counseling, please call:
Contact Western Reserve Hospital Patient Account Services at (330) 255-3101
Representatives are available Monday through Friday from 9:00 a.m. - 12 p.m. and from
1 - 4:30 p.m.
Notice to Ohio Residents—Ohio Hospital Care Assurance Program (HCAP): Western Reserve Hospital provides, without charge to the individual, basic, medically necessary hospital-level services to individuals who are residents of Ohio, are not Medicaid recipients, and whose income is at or below the federal poverty line. Covered services are inpatient and outpatient services covered under the Ohio Medicaid Program, with the exception of transplantation services and services associated with transplantation. Recipients of Disability Financial Assistance qualify for assistance. Ohio residency is established by a person who is living in Ohio voluntarily and who is not receiving public assistance in another state. Requests for financial assistance for Ohio residents are processed for HCAP first, and then are otherwise subject to the provisions of this HFA policy.