Charity Care Program

Charity Care Program

At Cape Fear Valley, we’re dedicated to serving the healthcare needs of our patients. To assist in meeting those needs, we have established a Charity Care Policy to provide financial relief to low-income, uninsured and medically indigent patients.

First, some definitions:

Charity (indigent) – household income that is equal or less than 200% of the Federal Poverty Guidelines. Qualifying applicants will be responsible for a co-pay, then will receive 100% assistance with their hospital obligation.

Uninsured – patients with no health insurance. All uninsured patients will receive a minimum of 30% discount.

Medically Indigent – patients who:

  • Have health coverage, but it does not provide full coverage for all their medical expenses, and
  • These medical expenses, in relation to their income, would make them indigent if they were forced to pay full charges.

Limited Means – Income between 250% and 500% of the Federal Poverty Guidelines. Qualifying applicants will receive partial assistance. Those who have limited means will receive care at a discount. Discounts are on a sliding scale and range from 45% to 85%.

Interest-Free Payment Arrangements – allows a patient up to six months to pay an outstanding balance without accruing interest.

How Does Cape Fear Valley Determine Eligibility?

Patients or guarantors must apply for the program by filling out the Application for Hospital Sponsored Charity (link below).

All third party resources and non-hospital financial aid programs, including Medicaid, must be reviewed before financial assistance can be requested.

The patient or guarantor must provide any or all of the following:

  • Income from all sources
  • Copies of statements from savings and checking accounts, certificates of deposit, stocks, bonds, money market accounts, etc.
  • Value of assets including home and real estate
  • Monthly expenses
  • Number of dependents
  • Copies of most recent pay stubs (three months)
  • Copies of most recent state and federal income tax forms, including documentation (see policy)

Charity Care Program Co-Pays

Patients approved for Charity Care will be required to pay a co-pay for each encounter at entities owned and operated by Cape Fear Valley Health System.

Co-pays are as follows per visit:

Primary Care Clinic Visit $25
Specialty Care Clinic Visit $35
Emergency Department Visit $50
ExpressCare Visit $50
Hospital Admission $100
Ambulatory Surgery $75
Ancillary Services (Lab, Radiology, etc.) $20

For full information on the Charity Care Program, please see the Charity Care Program Guidelines Policy below.

Charity Policy
Charity Application