Financial Assistance

Financial Assistance

Memorial Hospital is proud of its mission to provide quality care to all who need it.

Memorial Hospital is committed to caring for our patients, including patients who financially are unable to pay for hospital services. We encourage patients to apply for financial assistance if they believe that they are unable to pay all or part of their hospital bills.

Learn about our financial assistance program by downloading policy information below:

Memorial Hospital Financial Assistance Policy

Memorial Hospital Financial Assistance Policy
Memorial Hospital Financial Assistance Policy

Download the Financial Assistance Policy pdf below or call 402-646-4704 to obtain a free copy of the financial assistance policy and financial assistance application form, through the mail.

Review the Plain Language Policy Summary

Review the Plain Language Policy Summary
Review the Plain Language Policy Summary

Here is a plain language summary of the policy.  Download the pdf below or call 402-646-4704 to obtain a free copy of the financial assistance policy and financial assistance application form, through the mail.

Apply for Financial Assistance

Apply for Financial Assistance
Apply for Financial Assistance

To complete the financial assistance application:

  • Download the application below.
  • Attach supporting documents, listed on the application, to prove your income.
  • Mail your completed application and necessary documents to Memorial Hospital Patient Accounts Department at 300 North Columbia Avenue, Seward, NE 68434.

You may obtain a free copy of the financial assistance policy and financial assistance application form, through the mail by calling our Patient Accounts Department at 402-646-4704. Spanish translations of these forms are also available.

A complete financial evaluation is required to determine your eligibility for financial assistance. Review and determination of eligibility may require 30 days after submission of the application. Patients will receive written notification following Memorial Hospital's determination.

See the List of Covered Providers

See the List of Covered Providers
See the List of Covered Providers

Our Financial Assistance Policy includes Memorial Hospital medical providers. Visiting specialists, pathology and radiology services are not subject to this policy. Access the list of covered providers by downloading the pdf below.

Need Help or Have Questions? We're Here for You.

Memorial Hospital is committed to serving our patients. Our patient accounts department is available to answer questions about the financial assistance policy and the application process. If you have questions about this process, please call 402-646-4704 or email us at patient.accounts@mhcs.us.