Financial Assistance and Other Support

Yes. If your insurance has paid part of the bill but you need help in paying your balance, you can apply for Financial Assistance. First, you should request help from a Minnesota Health Care program. If the county denies you help, we will review the denial. We may be able to help you with one of our Financial Assistance programs.

Yes. Uninsured patients who live in and have an active address within the United States will receive a discount on medically needed hospital services. The discount will show up on your bill. People who receive the uninsured discount may also apply for Fairview’s Financial Assistance program.

We have payment plans to help you pay your bills. After looking at all payment options, you may qualify for financial help. You can call 612-672-6724 (Hours: M-Th 8:00am - 5:30pm, F 9:00am - 4:30pm) to speak with our customer service team about financial assistance. Learn more about financial assistance for patients.

For more information about Fairview’s Financial Assistance program, please call the number on your bill. If you have not received a bill, call Patient Financial Services at 612-672-6724. For more information about Fairview Range Financial Assistance program, please call Patient Financial Services at 218-362-6624 or (toll-free) 877-390-6624.

Thank you for your interest in Fairview’s Financial Assistance program.

To apply, review the instructions below and complete our Financial Assistance application form. The application is also available Spanish, Somali, Vietnamese, Hmong and Karen.

Step 1: Complete and sign this form.

• List the names and birth dates for each family member applying for the program. If you do not list them on the form, they will not be included.
• If your spouse is also applying for this program, both of you must sign the form.
• Your family includes a spouse, dependent children and any person for whom you have legal guardianship.

Step 2: Attach these items to the form. We will keep your records confidential (private). Please include records for all adults in your household.

• A copy of your most recent 1040 Federal Income Tax form. Do not include W2 forms.
• Records of income are to include copies of the two most recent payroll stubs. (Example: pay stubs that show your year-to-date earnings.)
• Copies of bank statements for all checking and savings accounts for the last 30 days. Include the last statement for any CDs (Certificates of Deposit).
• Records of all retirement savings: employee pension plans, 401K plans, 403b plans, annuities, IRAs.
• Record of current balances in all health savings accounts (HSA).
• Optional: a letter explaining any recent events that might affect your ability to pay your medical bills.

Step 3: Return the form with the above records to the following address:

Patient Financial Services
Attn:  Financial Assistance
1700 University Ave W
6th Floor
St Paul, MN 55104

Step 4: If you have applied for insurance coverage via MNsure or the Affordable Care Act, send the application results.

You will keep receiving bills until we have your complete application. This includes the records listed above. If there are legal fees related to your account, you are not eligible for financial assistance.

Income Guidelines

If you qualify for the program, up to 100 percent of your bill may be paid depending on your gross annual income, family size and asset guidelines. You must comply with all the terms of the program when you apply, and we also ask you to follow the rules set by your insurance plan.

Asset Guidelines

If a family has total assets in bank accounts, stock assets, and retirement totaling more than $100,000 they are not eligible for Financial Assistance.

Yes. First, you must apply for state or county aid in your state. If your state denies your request, we will review your Financial Assistance application. If you are approved for Fairview's Financial Assistance program, you may receive a 50 to 100 percent discount on your eligible hospital and clinical bills.

To request an application by mail, please call 218-362-6624. We will mail an application to you along with a list of the required documents, including proof of your income and property. You can also download an application here. All applications should be returned to Fairview Range’s Financial Advocates at the Main Campus (750 E 34th Street, Hibbing, MN 55746) in-person or by mail.

Provider Lists

Fairview has a list of all provider groups that provide emergency and medically necessary services to patients at a Fairview Hospital facility. The list identifies which providers are and are not covered by Fairview’s Financial Assistance Policy.

• Fairview Health System Covered Provider List
• Fairview Health System Non-Covered Provider List

Following a determination of financial aid eligibility, a financial aid-eligible individual will not be charged more than the amount generally billed (AGB) to individuals who have insurance for emergency or medically necessary care.

English, Amharic, Arabic, Chinese, Hmong, Karen, Oromo, Russian, Somali, Spanish, Vietnamese.

You may qualify for discounted care based on your household income and assets. Your income may be up to four times (400%) the Federal Poverty Level.

Covers: Emergency and medically needed care

Does not cover: Out-of-network services (based on your insurance) or care provided by a non-Fairview doctor

For more information, visit our Financial Assistance page.

No single organization can meet the needs of all patients who are unable to pay. Patients who need financial help should use all resources for which they qualify.

Fairview bases eligibility for financial assistance on your household income, your income’s percentage of the Federal Poverty Level, your family size, and your assets. Based on what benefit you qualify for, you may receive a 100% discount. If not a 100% discount, you may receive either an Amount Generally Billed (AGB) discount or uninsured discount, whichever discount is higher. You can find information about the AGB discount here.

For more information, please refer to the Financial Assistance Policy

Yes. Fairview and Senior Community Services are partners to provide help to low-income seniors who do not qualify for Medical Assistance. Fairview has agreed to waive Medicare co-insurance and deductibles for health care services. Call Senior Partners Care administered by the Seven County Senior Federation at (320) 679-4700 or email MP@7countyseniors.org.

If you have an appointment to apply for Medical Assistance or MNCARE with us, please bring:

Insurance documents

• Minnesota Health Care Programs Renewal form if you have it
• Health insurance card if you have one
• MNsure account information if you already have an account

Financial and job-related documents

• Pay stubs from the past 30 days, or if you are self-employed, bring your most recent tax return
• Documents to verify any other sources of income such as unemployment or Social Security. You do not need to provide information around Supplemental Security Income (SSI), child support, worker's compensation, or veterans' benefits.
• Appendix A – Health Coverage from Jobs form: If anyone in your household is offered insurance through an employer, please ask your supervisor or HR contact to fill out this form.

Identification documents

• Your driver's license or photo ID
• Date of birth for everyone in the household
• Social Security number for every person applying
• Permanent Resident Card or other immigration documents if applicable

 Please visit our page on paid family medical leave to learn more about documentation requirements.