Financial Assistance


BILLING LINKS
Billing Home Page
Insurances
The Billing Process

The John C. Fremont Healthcare District offers reduced rates a financial assistance program is designed to assist patients who may not have the ability to pay their hospital bill(s). The level of assistance provided is based upon the review of an individual's economic condition which includes income level (based on the Federal Poverty Levels) and assets held. You may be eligible for a partial to full write off on your account. Accounts that qualify are also eligible for a longer repayment time on the remaining balance, interest free.

The application is only for charges with John C. Fremont Healthcare District. The application does NOT cover the Emergency Physicians, Hospitalists, Radiologists and other contracted services, or billing for any entity other than John C. Fremont Healthcare District.

Based on the 2017 Federal Poverty Guidelines, issued yearly by the Department of Health and Human Services.


Applying for Financial Assistance Instructions:
You may download the District's application in English or Spanish. Or, call 209-966-3631, ext. 5130 to request one be mailed to you, or to answer any questions about the process.

Financial Assistance Application (English)

Financial Assistance Application (Spanish)


Complete the application and return it with the required documentation to the Financial Services Department.

BILLING LINKS
Billing Home Page
Insurances
The Billing Process
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Contact Us

John C. Fremont
Healthcare District

Attn:
Matthew Matthiessen, CEO/CFO
P.O. Box 216
Mariposa, CA 95338-0216
209-966-3631   ext. 5101
209-966-3776   Fax
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