- Admitting/registration areas of any of the Memorial Healthcare System acute care facilities (located near the main lobby of each facility)
- Eligibility Office: Monday-Friday, 8 am to 4:30 pm (office is closed to the public)
Our eligibility team will help you find financial assistance programs that are a good fit for you.
How to Apply for Financial Assistance
To apply for financial assistance with the healthcare system, you will need to complete a financial evaluation form and meet with our eligibility team.
Our Eligibility Office is currently closed, but you can make an appointment by calling 954-276-5500 Monday-Friday, 8 am to 4:30 pm, .
You will need to email, fax or mail the following documents:
- A financial evaluation form which you should print and fill out
- Past three months of bank statements
- Current utility bill
- Florida driver's license or photo identification
- Employer wage stubs for three months
- Income Tax Return
The eligibility team will confirm your current income level to see if you qualify for any federal or state programs during your appointment. If you do not qualify for any federal or state programs, we will research which assistance program you qualify for. The assistance programs are based on the current Federal Poverty Guidelines and offer a sliding scale of assistance for any uninsured or underinsured patient that has an annual family income that is less than 400% of the Federal Poverty Guideline. Assets (excluding your primary home and your primary vehicle) are considered a part of your annual income.
