Patient Financial Assistance Program and Application

Fletcher Allen Health Care is a patient-centered organization committed to treating all patients equitably, with dignity and respect regardless of the patient's health care insurance benefits or financial resources. We are committed to providing financial assistance to persons who have essential health care needs and are uninsured, underinsured, ineligible for a government program or otherwise unable to pay, for medically necessary care based on their individual financial situation.

Your ability to pay for services should not prevent you from receiving the medically necessary care you need. Fletcher Allen Health Care has financial assistance programs in place to help you, in the form of discounted, or free care for those patients who do may not have the financial resources to pay their bills.

View the Patient Financial Assistance Policy Summary.

Financial Assistance Discounts

For the uninsured patient, Fletcher Allen Health Care offers a discount for medically necessary care. Note: Cosmetic, non-medically necessary (e.g., IVF, Sterilization reversals), case rate services, are some examples of services not eligible for the discount.

  • Fletcher Allen Health Care uninsured discount = an uninsured patient is one who is not enrolled in a third party health insurance plan. 
  • If single service provided is >$5,000 an additional prompt pay discount may be  available 
  • To receive the additional discount, payment in full is due at time of service.

For our international patients, Fletcher Allen Health Care offers a discount for care if paid in full at time of service. Please contact our Financial Counselors at fahcpfc@vtmednet.org for more information.

Patient Assistance (Free Care / Charity Care)

For our patients who express financial hardship, Fletcher Allen Health Care offers free or discounted assistance programs, sometimes referred to as "charity care".

Our program is based upon the Federal Poverty Level Guidelines (FPLG) and eligible patients must pass both an income and assets test to qualify. In addition:

  • Patients must live in our service area. They must be full time Vermont residents or residents living greater than 6 months in Vermont, or in the following New York counties: Clinton, Essex, Franklin, Washington, Hamilton, Warren or St. Lawrence. Or New Hampshire counties: Coos, Grafton or Sullivan.
  • Patients living outside of the service area would qualify for emergency care only
  • Service must be medically necessary (e.g. Birth Control, Cosmetic, IVF, Sterilization reversals, are not eligible)
  • Under the new health care reform, all U.S. citizens are required to have insurance
  • Patients are required to apply for Medicaid or Vermont Health Connect to be considered for this program
  • Patients income and assets must be below 400% of the FPLG
  • Patients above 400% of the FPLG are invited to apply and present extenuating circumstances in the form of a letter to be reviewed by an appeals committee
  • If services are above 400% of the FPLG and are catastrophic in nature, coverage is available when the balance due exceeds 30% of the annual household income

VT Federal Poverty Level Guidelines

<=200%

201-250%

251-300%

301-350%

351-400%

Grant Assistance

100%

85%

75%

65%

55%

 

To be considered for the financial assistance program, please complete the Patient Assistance Application (PAP) form and return, along with the required supporting documentation to:

Fletcher Allen Health Care, Inc.
P.O. Box 1810
Burlington, VT 05402-1810
Attn: Patient Assistance Program

If you have questions regarding our financial assistance programs or application status, please contact our Customer Service department at (802) 847-8000 or (800) 639-2719 or via email at customerservice@vtmednet.org.

If you have any questions or need assistance with the applications process for Vermont or New York Medicaid, please contact our Financial Counseling department at (802) 847-1122 or via email at fahcpfc@vtmednet.org.

Government-Assisted Programs

The State of Vermont’s Green Mountain Care is a family of low-cost and free health coverage programs for Vermonters. Green Mountain Care provides uninsured Vermonters with access to quality, comprehensive health care coverage at a reasonable cost. Programs include Dr. Dynasaur and Medicaid. Learn more about these programs or find answers to questions you may have about what program may be best for you by visiting www.greenmountaincare.org.

Vermont Health Connect

If you are an individual or own or work for a small business, Vermont Health Connect is where you should go to enroll in a health plan. 

If you are currently enrolled in VHAP or Catamount, your coverage is ending. You should have received a notice in the mail telling you if are eligible for expanded Medicaid coverage, or if you need to enroll in a private plan through Vermont Health Connect. Financial Assistance is available for most Vermonters who buy a health plan through Vermont Health Connect.

For information about plans available through Vermont Health Connect, please visit www.vermonthealthconnect.gov. 

For more information about Medicaid or Dr. Dynasaur, please visit www.greenmountaincare.org.


Related Documents

Patient Financial Assistance Program Application Download PDF
Patient Financial Assistance Policy Summary Download PDF


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