Mail:
LifeBridge Health
Attn: Customer Service
5401 Old Court Rd.,
Randallstown, MD 21133
Phone:
1-800-788-6995
Do You Need Help Paying Your Hospital Bill?
LifeBridge Health complies with all applicable federal civil rights laws. Our organization does not discriminate against, exclude or treat any patient differently based on race, color, national origin, age, disability, sex or sexual orientation, or gender identity/expression.
Financial hardship doesn't have to be an obstacle to your care. LifeBridge Health hospitals (Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale and Grace Medical Center) can provide assistance, including discounts, to financially disadvantaged patients (including the uninsured or underinsured) who qualify.
Eligibility
Patients and families with an annual income up to 300% of the federal poverty level may qualify for discounts up to 100% of their hospital bill.
For example, you may qualify if your income is lower than the amounts applicable to your family size in the table below (for each additional person, add $1,375 monthly or $16,500 annually):
How To Apply
|
Uninsured & Underinsured 100% Discount |
||
|---|---|---|
| Family Size | Earnings Period | up to 300% FPL |
| 1 | Monthly | $3,912.50 |
| Annual | $46,950 | |
| 2 | Monthly | $5,287.50 |
| Annual | $63,450 | |
| 3 | Monthly | $6,662.50 |
| Annual | $79,950 | |
| 4 | Monthly | $8,037.50 |
| Annual | $96,450 | |
| 5 | Monthly | $9,412.50 |
| Annual | $112,950 | |
Which Providers and Hospitals Participate?
Each LifeBridge Health hospital participates in the Financial Assistance Program. However, charges for physician services are billed separately and may not be covered by our financial assistance policy. For more information about services and providers covered under our policy, please click below.
How to Apply
Applying is simple. You can request a financial assistance application by calling Customer Service at 1-800-788-6995, visiting the Customer Service area at the hospital where you received care, or asking a registration representative. You can personally submit your completed application to Customer Service or a registration representative, fax it to 401-601-4031 or mail it to:
Attn: Customer Service
5401 Old Court Rd.,
Randallstown, MD 21133
Please note that additional documentation may be requested in order to help us make a determination. Most determinations are completed within 14 business days. You will receive either a letter by mail or a telephone call about your eligibility. For additional information, call Customer Service at 1-800-788-6995.
More Information
Plain Language Summary
Financial Assistance Application
Financial Assistance Policy
Billing and Collections Policy
Changes Are Coming to Maryland Medicaid
Medicaid renewals will not be automatic this year and require action on your part. Check in to make sure your contact information is up-to-date so you can receive important notices on any changes to your health insurance.
