Financial Assistance Program Summary
Doctors’ Memorial Hospital is committed to meeting the healthcare needs of the community. As a not-for profit hospital, Doctors’ Memorial Hospital provides emergency and medically necessary services to all patients without regard to status or ability to pay.
If you anticipate any difficulty in paying your hospital or clinic bill, or, if you would like to apply for financial assistance, please contact our Patient Financial Services representative at, 850-584-0862, or 850-584-0863
Monday – Friday 8 am to 4:30 pm. You may obtain a copy of the financial assistance application HERE.
You may also obtain a paper copy of the financial assistance policy and application form at any registration location of the hospital, DMH Clinics or, the Business Office.
The DMH Financial Assistance Policy and Procedure can also be found HERE.
A patient or their representative may request financial assistance prior to receiving, while receiving or after receiving services at Doctors” Memorial Hospital. The eligibility determination shall be applied regardless of race, color, creed, sexual orientation or immigration status. Applications are processed for all who complete the application process. Financial assistance is administered on an individual basis taking into consideration your income, family size and other specific needs or circumstances.
The Application Process
All patients requesting financial assistance must complete a Financial Assistance Application. The applicant is required to provide documentation that supports their family’s current level of income, available assets and expenses. Examples of income include tax returns, W-2 forms; Social Security benefits disability statements, etc. If you cannot provide these documents, you may still be able to apply. Please schedule an appointment with our Patient Financial Services representative by calling 850-584-0862. Or 850-584-0863.
Financial Assistance Decision and Notification Process
Doctors’ Memorial uses Federal Poverty Guidelines issued by the U.S. Department of Health and Human Services to determine a patient’s eligibility for financial assistance. The amount of discount varies based on your income and family size. If your income, adjusted for family size is 200% of the poverty level or lower, financial assistance may be provided. If your income is above 200% of the Federal Poverty Levels, other discounts may apply. The applicant will be notified within 30 calendar days of receipt of a complete application.
Contacting the Financial Assistance Program at DMH
Patient Financial Services representatives are available to assist you in understanding the financial assistance program and to answer any questions you may have. Should you need assistance in any other language besides English, the program may be able to provide a translator for you. The financial counselor will also be able to assist or inform you of other programs such as Medicaid, Disability and Vocational Rehabilitation Services that may assist you with your hospital bill. Our financial counselors will also be able to direct you to healthcare navigators within our community that can assist you with finding insurance through the market-place exchange.