Navigating Hospital Inpatient Program Costs: Financial Aid at Nationwide Children’s

Understanding the financial aspect of hospital care can be overwhelming, especially when your child needs medical attention. Nationwide Children’s Hospital recognizes these concerns and offers a range of financial assistance programs to help ease the burden for families. This guide outlines the various aid programs available, helping you understand the potential costs of inpatient programs and how to access support.

Nationwide Children’s Hospital is dedicated to providing healthcare to everyone in need, regardless of their ability to pay. They offer financial assistance to patients who are unable to afford medical care. Before applying for hospital aid, patients are expected to explore all other available resources, including applying for assistance from local Department of Job and Family Services. Eligibility for financial aid is determined based on gross household income and the number of dependents. Special circumstances are also considered for further assistance.

Download the Financial Assistance Policy

Download the Plain Language Summary of the Financial Assistance Policy and Application

Download the Financial Assistance Policy Provider Listing (updated October 2024)

Understanding the Hospital Care Assurance Program (HCAP)

Ohio’s Hospital Care Assurance Program (HCAP) mirrors the federal Disproportionate Share Hospital Program. It’s designed to cover hospital services for Ohio residents with incomes below 100% of the federal poverty level who do not qualify for Medicaid. It’s important to note that HCAP applies only to hospital bills. You must first bill all insurance providers and third-party payers before applying for HCAP. Assistance is provided only for the portion of the bill that remains the patient’s responsibility.

HCAP Eligibility Criteria:

  • Residency in the State of Ohio is mandatory.
  • Household income must be at or below the Federal Poverty Level (see income chart provided later in this article).
  • Applicants must not be currently receiving Medicaid benefits.

Download the Financial Assistance Application (for the Spanish version click here).

For further inquiries about HCAP, please contact Nationwide Children’s at (614) 722-2055.

Healthy Start & Healthy Families Programs

Healthy Start and Healthy Families programs aim to provide affordable healthcare coverage to families, children under 19, and pregnant individuals. These programs offer free or low-cost coverage encompassing doctor visits, inpatient hospital care, and pregnancy-related services. Coverage extends to medications, vision and dental care, substance abuse treatment, mental health services, and more. Healthy Start is specifically structured to support working families.

Healthy Start Qualification Guidelines:

  • For Children: Household income at or below 206% of the Federal Poverty Level (FPL).
  • For Insured Children: Household income at or below 156% of the Federal Poverty Level.
  • For Pregnant Women: Household income at or below 200% of the Federal Poverty Level.
  • Healthy Families Qualification: Household income at or below 90% of the Federal Poverty Level.

Application Assistance: To apply, reach out to the Ohio Department of Job and Family Services (ODJFS) through these channels:

  • Phone: 1-800-324-8680 or TDD 1-800-292-3572
  • Contact Nationwide Children’s directly at (614) 722-2070
  • Visit the ODJFS website: Ohio Medicaid official website

Complex Medical Help (CMH) Program Details

The Complex Medical Help (CMH) program is designed to assist with expenses related to the diagnosis, treatment, and ongoing care for children with medical handicaps. Families may be eligible for full CMH coverage or a cost-share program, based on their financial situation. It’s necessary to first apply for and utilize other health insurance options, such as Healthy Start or private insurance, before seeking CMH benefits.

CMH Eligibility Requirements:

To qualify for CMH, a child must:

  • Have a medically handicapping condition that is eligible under CMH guidelines.
  • Be under 21 years of age for the Diagnostic Program.
  • Be under 23 years of age for the Treatment Program.
  • Be a resident of Ohio.
  • Be under the care of a CMH-approved physician.

Connecting with CMH:

Medicaid for Disabled and Aged Individuals

Medicaid coverage is available for children and adults with permanent or long-term disabilities. This program offers comprehensive benefits for a wide array of healthcare services, including hospital care, doctor visits, in-home care, and necessary medical equipment for home use. Eligibility for this Medicaid coverage requires application and qualification for Supplemental Security Income (SSI) or Social Security Disability Income (SSDI).

For more information, please call Nationwide Children’s at (614) 722-2070.

Health Care Exchanges and the Affordable Care Act (ACA)

The Health Care Exchanges, established under the Affordable Care Act (ACA) in October 2013, provide a marketplace for individuals and families to explore and enroll in health insurance plans. This online platform allows you to:

  • Shop for health insurance plans available in your state.
  • Compare different health plan options side-by-side.
  • Purchase and enroll in a health plan that meets your needs.

Explore health insurance options at: www.healthcare.gov

Learn More about healthcare insurance plans at Nationwide Children’s

Alien Emergency Medical Assistance (AEMA) Details

Alien Emergency Medical Assistance (AEMA) is a Medicaid program designed for certain immigrants who require coverage for emergency medical conditions. Eligibility for AEMA is determined by the County Department of Jobs and Family Services, who will assess the individual’s immigration status and Medicaid eligibility. U.S. citizenship is not a requirement for AEMA qualification.

For inquiries regarding AEMA, please contact Nationwide Children’s at (614) 722-6855.

Connect with Financial Counselors at Nationwide Children’s Hospital

Dedicated financial counselors are available at Nationwide Children’s Hospital to assist you.

Counselors Location Phone
Nationwide Children’s- Financial Counselors Admitting Office (614) 722-2070
Franklin County – Caseworker Admitting Office (614) 722-6855
Nationwide Children’s – Customer Service Patient Accounts (614) 722-2055

For broader financial support information, please visit Financial Support Resources. You can also call Nationwide Children’s at (614) 722-2055 for immediate assistance.

2025 Poverty Income Guidelines

Below are the Federal Poverty Level income guidelines, effective January 17, 2025, to help determine eligibility for various programs:

Family Size Income 100% FPL Income 150% FPL Income 200% FPL Income 300% FPL Income 400% FPL
1 $15,650 $23,475 $31,300 $46,950 $62,600
2 $21,150 $31,725 $42,300 $63,450 $84,600
3 $26,650 $39,975 $53,300 $79,950 $106,600
4 $32,150 $48,225 $64,300 $96,450 $128,600
5 $37,650 $56,475 $75,300 $112,950 $150,600
6 $43,150 $64,725 $86,300 $129,450 $172,600
For each additional person, add $5,500 $8,250 $11,000 $16,500 $22,000

Nationwide Children’s Hospital is here to support you through the financial aspects of your child’s care. Do not hesitate to reach out to their financial counselors to discuss your situation and explore available aid programs.

Comments

No comments yet. Why don’t you start the discussion?

Leave a Reply

Your email address will not be published. Required fields are marked *