Download PDF version of this page Financial Assistance Offered: UW Medicine offers financial assistance, under its Financial Assistance Policy, to eligible patients who are unable to pay for emergency or other medically necessary care. UW Medicine provides financial assistance for any patient/guarantor whose gross family income is up to 400% of the Federal Poverty Level (FPL) and adjusted for family size after any third-party coverage has been exhausted. For facility and/or professional services at Airlift Northwest, Harborview Medical Center, UW Medical Center, UW Physicians, UW Medicine Primary Care, and Valley Medical Center: 0% - 300% of the FPL for a 100% financial assistance discount For facility services only with discharge dates on or after July 1, 2022 at Harborview Medical Center, UW Medical Center, and Valley Medical Center: 301% - 350% of the FPL for a 75% financial assistance discount 351% - 400% of the FPL for a 50% financial assistance discount For Valley Medical Center, an individual who is eligible for financial assistance cannot be charged more than the amounts generally billed for emergency or other medically necessary care.Eligibility Requirements and Assistance Offered: Eligibility for financial assistance is based on many factors including the nature of the condition and care required, insurance coverage or other sources of payment, income, family size, assets, WA state residency and any special considerations the patient or provider wuld like to have considered. Patients seeking financial assistance must comply with the Financial Assistance application process. This includes submitting the patient’s W-2 statement, current pay stubs, bank statements or last year’s income tax return, and completing the application process for all available sources of assistance, including state subsidized care (Medicaid).How to Apply for Assistance: The patient or any person involved in the care of the patient, including a family member or provider, can express financial concerns. The patient or responsible party will then be encouraged to complete a financial assistance application. To qualify for financial assistance, an application can be submitted at any time prior to an account receiving a court judgment.What is Eligible for Assistance: Financial assistance is limited to medical care provided at a UW Medicine location by UW medical personnel. Expenses such as travel, food, lodging, and durable medical equipment are not covered under the Financial Assistance policy. Prescriptions may be covered for patients up to 300% of the FPL for a 100% financial assistance discount if written by a UW Medicine provider and filled at a UW Medicine pharmacy (if available).Where to Obtain Copies, Submit Documents and Contact Information: UW Medicine Financial Assistance Policy, Financial Assistance Application, Plain Language Summary, and Billing & Collection Policies are available free of charge. These documents can be accessed in multiple languages online, by phone or in person. Documents are online to download or print at uwmedicine.org/financialassistance or valleymed.org/financialassistance. You can ask for your copy in person or by phone from the location where you are seeking care. For the Financial Assistance application and supporting documents in English, you can now utilize MyChart (except Airlift Northwest) to submit your documents based on your care location. For all other application submissions continue to submit by mail, fax, or in person. Any information submitted for consideration will be treated as protected health information under the Health Insurance Portability and Accountability Act (HIPAA). Harborview Medical Center UW Physicians UW Medicine Primary Care Financial Counseling 325 9th AveMail Stop 359758Seattle, WA 98104-2499 206.744.3084FAX 206.744.5187 M-F 8:00 a.m. – 4:30 p.m. mychart.uwmedicine.org UW Medical Center-Montlake UW Physicians UW Medicine Primary Care Financial Counseling 1959 NE Pacific StreetMail Stop 356142Seattle, WA 98195-6142 206.744.3084FAX 206.598.1122 M-F 8:00 a.m. – 4:30 p.m. mychart.uwmedicine.org UW Medical Center-Northwest UW Physicians UW Medicine Primary Care Financial Counseling 1550 N 115th StSeattle, WA 98133-9733 206.744.3084 M-F 8:00 a.m. – 4:30 p.m. mychart.uwmedicine.org Valley Medical Center Patient Financial Services P.O. Box 59148 Renton, WA 98058-2148 425.690.3578 FAX 425.690.9578 M-F 8:00 a.m. – 5:00 p.m. mychart.valleymed.org/#mychart Valley Medical Center Patient Financial Services 3600 Lind Ave SW, Suite 110Renton, WA 98057-4970 425.690.3578 FAX 425.690.9578 M-F 8:00 a.m. – 5:00 p.m. mychart.valleymed.org/#mychart Airlift Northwest Patient Financial Services 6505 Perimeter Road S., Ste 200Seattle, WA 98108 206.598.2912 FAX 206.521.1612 M-F 8:00 a.m. – 5:00 p.m.