We know your first concern is to be healthy and happy, so we offer financial assistance to help you overcome potential obstacles that medical bills may present to getting the care you need.
For questions related to financial assistance, call
How to apply for financial assistanceComplete a financial assistance application (see language choices below) and attach the following documents (if applicable):
- Most recently filed Federal Income Tax Return
- Four (4) most recent paystubs
- Four (4) most recent bank statements
- Social Security Income determination
- Unemployment income
- Pension income
- Distribution confirmation from estates or liability settlements (financial assistance will not be considered until the final settlement of the estate or litigation)
- Medical assistance or health insurance marketplace
- Proof of citizenship or lawful permanent residence status (green card)
- If household has no income, letter from person(s) who assist with living expenses
- Any other information deemed necessary by Milton S. Hershey Medical Center to adequately review the financial assistance application to determine qualification for financial assistance.
All applicants will be notified by phone or letter when a determination has been made regarding the financial assistance qualification.
In compliance with Internal Revenue Service (IRS) regulations ‒ IRS Code 501(r) ‒ Penn State Health hospitals and medical practices:
- Have a written financial assistance policy (FAP) and “plain language summary” of the policy available to the public
- Limit the amounts that can be charged for emergency or other medically necessary care to individuals eligible for financial assistance, charging only “Amounts Generally Billed” for such care
- Refrain from extraordinary collection actions before making reasonable efforts to determine whether an individual qualifies for financial assistance
Penn State Health Milton S. Hershey Medical Center and its Medical Group practices instituted revised financial assistance policies and processes on July 1, 2016. Under this policy, patients who qualify will receive 100% financial assistance for medically necessary services.
You can download information on financial assistance below, including the FAP and plain language summary.
- Polizza di Assistenza Finanziaria (policy)
- Pazienti che hanno bisogno dell’Assistenza Finanziaria (application)
In addition to standard financial assistance plans, we offer other services to help you pay your balance:
- Interest-free payments: We do not charge interest on health care balances or charge a fee for carrying a balance.
- Pharmacy assistance: If you have a problem paying for prescription drugs, we can connect you with our pharmacy specialist. She can work with you to find equal, low-cost prescriptions or other pharmacy programs directly from drug companies.
- Four Diamonds: This charity offers financial assistance for children who are diagnosed with cancer before the age of 18. The charity often assists with out-of-pocket medical expenses, lodging, and transportation.