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.
Financial Assistance Policy Summary
The Nicklaus Children’s Hospital Financial Assistance Policy was established in order to identify and assist patients who lack the financial resources to meet all or part of their financial liability for services rendered and to determine their eligibility for financial assistance. This is a summary of the Financial Assistance Policy.
The Financial Assistance Policy assures that patients who are unable to pay hospital charges are evaluated for financial assistance eligibility on a nondiscriminatory basis. The policy is consistent with the mission and values of Nicklaus Children’s Hospital and takes into account each patient’s ability to pay the cost of his or her care. Nicklaus Children’s Hospital is committed to ensuring
a financially sound organization so that it may continue to provide outstanding medical care with a highly skilled work force employing the latest advances.
Patient Eligibility and Discounts Offered
Patients will be considered for 100 percent financial assistance if their family income for the past 12 months is 200 percent or less of the federal poverty guidelines. Patients will also be considered for 100 percent financial assistance if the patient’s combined responsibility for hospital and/or affiliated physician services from a single episode of care exceed 25 percent of annual family income. All attempts at insurance reimbursement must be exhausted before financial assistance eligibility can be considered. Certain geographical residence requirements may apply. No patient eligible for financial assistance will be charged more for emergency or other medically necessary care than the amounts generally billed to individuals who have insurance coverage.
The criteria for determining financial assistance eligibility is reviewed annually by Nicklaus Children's Health System.
What services are eligible for financial assistance?
- The Financial Assistance Policy applies to charges for emergency or other medically necessary services provided by Nicklaus Children’s Hospital (and its affiliated physicians), and at all Nicklaus Children’s ambulatory care centers. Elective services are not eligible.
Other Governmental Programs Available
Florida KidCare offers healthcare coverage for children under the age of 19 who qualify. Applications are accepted all year long! Learn more today.
Financial Application Process and Forms
Nicklaus 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
- Financial Assistance Policy
- List of Providers (Attachment B)
- Financial Evaluation Application (Attachment C)
- Financial Assistance Policy Summary
Nicklaus Children's Hospital
The completed application and supporting documentation should be mailed to:
ATTN: PFS - Financial Assistance
3100 SW 62 Avenue
Miami, Florida 33155
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