Applying for Financial Assistance

Health care can cost a lot and MaineHealth is here to help

If you need help paying for health care services, the first step is to complete an application for financial assistance. Even if you have health insurance, financial assistance can help you pay for co-pays, deductibles, co-insurance and more. To begin, complete and submit the application with all requested materials. Be sure to follow all instructions on the application form.

Who is eligible for financial assistance?

Eligibility is based on the gross income (total income before any deductions) that your household received in the last 3 months. You will need to provide "proof of income" documents such as:

• Most recent federal tax return, if you were required to file
• Most current 13 consecutive weeks of pay stubs
  • Depending on your income, this may be:
    • 13 pay stubs if paid weekly
    • 7 pay stubs if paid bi-weekly
• If self-employed, last 3 months itemized profit & loss statement
• Current year’s Social Security Benefit letter/pension statement, etc.
• Current General Assistance letter
• Unemployment or compensation benefits statement
• Other proof of income you have received in the past 3 months, such as child support, alimony, stipends, lottery winnings, or bonuses

What if I don't have any income? 

Provide a statement explaining your current situation and how you are being supported. If you are living off savings, provide your last 3 months of bank statements.

What happens after I submit an application for financial assistance?

Once we get all your information, you can expect to hear from us within 30 days. We may contact you for additional information. Approval is not a guarantee of financial assistance. Some exclusions apply. During the financial assistance application review process, your billing accounts will continue to age. To prevent collections, you must stay involved in the process and respond to any requests for additional information. Payment plans require a credit card or banking information on file.

If you have any questions, please send a message to Customer Service in MyChart, or call 1-866-804-2499 (toll-free) Monday through Friday, 8 am – 4:30 pm.