Financial Assistance Eligibility

Thank you for using our Eligibility Checker for Financial Assistance! Answer the following questions to see if you may be eligible for a discount on your Pana Community Hospital bills.

Name

First NameLast Name

Date of Birth

MonthDayYear

Do you have health insurance?

Including yourself, how many people are in your immediate family?

"Family" is defined as the applicant, the applicant's spouse, and all of the applicant's children under the age of 18 (natural or adoptive) who live in the applicant's home.

What is your estimated gross MONTHLY household income?

This is current household monthly income before taxes.