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Patients Billing & Insurance Financial Assistance Program

Financial Assistance Program

Your Options  

Let’s figure out all of your options:

  • Charity Care eligibility
  • Insurance Plans
  • Interest-free payment plans
  • Medicaid eligibility
  • Foundation Funds

Memorial Hospital’s Financial Assistance Program (FAP)  

Memorial Health System has a team of financial assistance counselors here to assist you with estimating your financial responsibility prior to receiving services and to assist you after you receive care.  NO ONE will be denied access to EMERGENCY services due to inability to pay.

Our team can assist you with enrolling in Medicaid, and/or determine a payment plan or financial assistance options.

Do you need medical care and don’t have health insurance?  Or, do you have insurance, but it’s not enough or can’t afford the high deductible?  If so, you may have options.  Please contact our financial assistance counselors to discuss your eligibility for different programs of assistance.   

To help find out if you are able to receive financial assistance, you will need to fill out a Financial Assistance Application and, provide proof of income.

Click to download:

Need help in filling out the application, please call (228) 867-4118 or (228) 867-7128.  Or, you can visit our Financial Assistance Office on the first floor of the hospital near the main lobby.

Sources of Financial Assistance

Memorial Hospital Foundation also offers financial assistance. The Foundation was established in 1986 as a 501(c)(3) non-profit organization with a vision to develop relationships and financial resources to support the healthcare programs, projects, and services of Memorial.  

The Foundation manages over 20 funds that provide financial support to Memorial Health System, our patients, and our employees. 100% of donations to the Foundation stay in our community and directly benefit the fund of our donors’ choosing. 

Some of these funds are directed to specific needs, such as, Breast Imaging Fund, Cardiac Patient Fund, Emergency Needs Fund, Oncology (cancer) Fund, Pediatrics Fund, Senior Services Fund, are all examples of funds that patient may be eligible to receive assistance from.

Visit Memorial Foundation Funds

This program must be accessed before any cancer diagnoses is made.

Eligibility Criteria

To qualify for MS-BCCP, a woman must meet all of the following guidelines:

  • Income: Household income at or below 250% of Federal Poverty Level. View income table
  • Insurance status: Uninsured, underinsured, or without third-party payers such as Medicaid or Medicare Part B
  • Resident: State of Mississippi for at least 12 consecutive months
  • Enrollment Age: 21-64 years old, as follows:
    • For cervical cancer screening: Age 21 to 64
    • For breast cancer screening: Age 40 to 64
      For women aged 40-49 years old, breast screening is offered. Providers must call BCCP for prior approval.
    • For breast or cervical diagnostic services: Age 21 to 64
  • Enrolled by: A contracted BCCP Provider
Learn More About MS-BCCP

Financial Assistance Program Policy

Eligible Services   

Emergent and/or medically necessary healthcare services provided by Memorial Hospital Gulfport, at any location, excluding office visits, cash package services and elective services.

Eligible Patients  

Patients receiving eligible services, who submit a Financial Assistance Application (including all supporting documentation in the time allotted), and who are determined eligible for assistance based on the guidelines of this policy.

Eligibility Period  

Patients have 240 days from the date of their first bill to return their completed application and the required supporting financial documentation to the Financial Counselors.  Applications are processed monthly and a determination letter will be sent to the patients after the final determination is made.

Determination of Financial Assistance Eligibility

With few exceptions, patients are eligible for financial assistance based on income levels and assets.  This eligibility is based on the Federal Poverty Limits set annually by the U. S. Department of Health & Human Services. Verification of eligibility is required so patients must provide documentation to support income and assets through the application process.  Failure to do so could mean denied assistance.  In some cases, Memorial Hospital may presumptively approve charity for individuals meeting certain criteria as outlined in the Financial Assistance Policy and may do so using a third party vendor.

View and Download the Financial Assistance Program Policy

Amounts Generally Billed

An eligible patient will not be charged more than the AGB for emergency or other medically necessary care charged to patients who have insurance.  The AGB is calculated based on the average of the three lowest commercially negotiated insurance rates. Financial Assistance discounts are applied to gross charges using this rate.

View and Download the Billing Compliance Policy

Collection Activities   

Memorial will make reasonable efforts to determine if a patient is eligible for Financial Assistance before making any extraordinary collection attempts.  Collection practices will be completed in accordance with the Memorial billing and collection guidelines.  Collection attempts may be completed by the hospital or a designated agency.  Non-payment will not be reported to a collection agency until a minimum 120 days after the first billing date.