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Financial Assistance Program

Our Mission is to inspire hope and promote lifelong health by providing the best care to every child. As part of our mission, it is of upmost importance to help those in need.  We provide gratuitous care to patients who do not have insurance and meet requirements for our financial assistance program.

Uninsured patients may qualify for discounts depending upon family income.  Certain geographical residence requirements may apply. Charity care assistance is available only for medically necessary services. Amounts due under the financial assistance program are limited to amounts generally billed to individuals with health insurance.
The criteria we use for determining financial assistance eligibility are reviewed annually. The criteria may be revised upward or downward by Miami Children's Health System.
 

Financial Application Process and Forms

Miami Children’s Health System is committed to providing charitable care to those in need. The Financial Assistance program provides assistance to uninsured patients for medically necessary health care services. It applies only to facility charges and employed physician charges. The policy does not apply to private-practicing physician charges or other independent company billings.

Your eligibility is based on your household income and other resources. The Financial Evaluation & Request for Financial Assistance must be completed in its entirety so that we may determine if you are eligible for assistance. We are happy to assist you with the application process.

In order to process your application, photocopies of one of the following documents are required for every member of your household. Your application will not be reviewed until this documentation is submitted.
  • W-2 withholding forms (most recent).
  • Paycheck stubs (dated within the last 60 days).
  • Income tax returns (for most recent year).
  • Forms approving or denying unemployment compensation or workers’ compensation (dated within the last 12 months).
  • A written verification of wages from employer (dated within the last 60 days).
  • A written verification from public welfare agencies or governmental agency which can attest to the income status for the past 12 months.
Also required are photocopies of the following proof of identification and address.
  • Valid photo identification
  • Proof of current address

 

Application Documents

  1. Financial Assistance Policy
  2. List of Providers (Attachment B)
  3. Financial Evaluation Application (Attachment C)
  4. Financial Assistance Policy Summary


Please note that a personal credit report may be obtained in connection with the evaluation of your application. You may contact an eligibility specialist at 305-669-6525 if you have any questions or need help with the application.

The completed application and supporting documentation should be mailed to:

Nicklaus Children's Hospital
ATTN: PFS - Financial Assistance
3100 SW 62 Avenue
Miami, Florida 33155
This information is also available upon request in the Patient Access Department or in any of our centers registration departments. If you need help with the financial assistance application process, an Eligibility Specialist is available by phone at 305-669-6525 or in the Patient Access Department.

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