Memorial Hermann Health System’s Financial Assistance Policy and Admissions Policy govern how financial assistance is provided. On the basis of these policies, a determination will be made regarding a patient’s eligibility for financial assistance.
Payment from all other possible payment sources must be exhausted before a patient can be considered for the financial assistance program. For patients who do not have insurance coverage, alternate funding and payment plan options may be available. Our staff or contracted agents work with patients to identify potential options.
Financial assistance may be available to patients who do not have the means to pay for their health care expenses and do not qualify for any government or other programs. A patient may qualify for Financial Assistance based on federal poverty guidelines.
To be considered for this program, patients are required to provide financial information for the household by completing a Financial Information Form along with supporting documentation. To verify income, the most current Federal Income Tax Return should be provided. Other pieces of supporting documentation may be requested in addition to or instead of the Tax Return, including: Last two Employer paycheck stubs, written documentation from income sources, and a copy of all bank statements for the last three months. Memorial Hermann reserves the right to review an applicant’s credit report, property tax records, and/or other public or personal documents prior to a determination regarding program eligibility. Please see policy for specific locations and services covered by our Financial Assistance Policy. Not all locations and services listed on our website are covered by the Financial Assistance Policy.
To request a Financial Information Form, please contact our Customer Service Department at (713) 338-5502 or see the forms section below.
Providers Not Covered Under MHHS’s Financial Assistance Policy
To prioritize the needs of the community, Memorial Hermann conducts Community Health Needs Assessments (CHNAs) for each of its hospitals every three years.
The qualitative and quantitative data collected includes a careful review of the most current health data available and input from numerous community focus groups as well as community representatives with special knowledge of public health on prioritizing community health needs and health care initiatives.
The resulting Strategic Implementation Plans (SIPs) set hospital-specific goals, objectives and strategies that address each facility’s specific service area and populations served. CHNAs and SIPs are available for the following facilities: