Download PDF version of this page Financial Assistance Offered: UW Medicine offers financial assistance, under its Financial Assistance Policy, to eligible patients unable to pay for emergency or other medically necessary care. Patients who choose UW Medicine benefit from our experience, expertise and the most advanced medical care available, all within one health system. “UW Medicine” includes Airlift Northwest, Harborview Medical Center, UW Medical Center, UW Physicians, UW Neighborhood Clinics, and Valley Medical Center. Eligibility Requirements and Assistance Offered: Eligibility for financial assistance is based on many factors including the nature of the condition and care required, insurance coverage or other sources of payment, income, family size, assets, WA state residency and any special considerations the patient or physician would like to have considered. Patients seeking financial assistance must comply with the Financial Assistance application process. This includes submitting the patient’s W-2 statement, current pay stubs, bank statements or last year’s income tax return, and completing the application process for all available sources of assistance, including state subsidized care (Medicaid). How to Apply for Assistance and What is Eligible for Assistance: The patient or any person involved in the care of the patient, including a family member or provider, can express financial concerns at any point. The patient or responsible party will then be encouraged to complete a financial assistance application. To qualify for financial assistance, an application can be submitted at any time prior to account receiving a court judgment. Financial assistance is limited to medical care provided at a UW Medicine location by UW medical personnel. Expenses such as travel, food, lodging, and durable medical equipment are not covered under Financial Assistance. Prescriptions may be covered if written by a UW Medicine provider and filled at a UW Medicine pharmacy (if available). Over the Counter (OTC) prescriptions are not covered under Financial Assistance. Where to Obtain Copies, Submit Documents and Contact Information: UW Medicine Financial Assistance Policy, Financial Assistance Application, Plain Language Summary, and Billing & Collection Policies are available free of charge. These documents can be accessed in multiple languages online, by phone or in person. Documents are online to download or print at uwmedicine.org/financialassistance or valleymed.org/financialassistance. You can ask for your copy by calling the location where you are seeking care. Copies are also available in person at the UW Medicine Admissions and Emergency Departments. For an English Financial Assistance application and supporting documents, you can now utilize MyChart (except Airlift Northwest) to submit your documents based on your care location. For all other application submissions continue to submit by mail, fax, or in person. UW Medicine will uphold the confidentiality and dignity of each patient. Any information submitted for consideration of financial assistance will be treated as protected health information under the Health Insurance Portability and Accountability Act (HIPAA). Harborview Medical Center UW Physicians UW Neighborhood Clinics Financial Counseling 325 9th AveMail Stop 359758Seattle, WA 98104-2499 206.744.3084FAX 206.744.5187 M-F 8:00 a.m. – 4:30 p.m. mychart.uwmedicine.org UW Medical Center-Montlake UW Physicians UW Neighborhood Clinics Financial Counseling 1959 NE Pacific StreetMail Stop 356142Seattle, WA 98195-6142 206.744.3084FAX 206.598.1122 M-F 8:00 a.m. – 4:30 p.m. mychart.uwmedicine.org UW Medical Center-Northwest UW Physicians UW Neighborhood Clinics Financial Counseling 1550 N 115th StSeattle, WA 98133-9733 206.744.3084 M-F 8:00 a.m. – 4:30 p.m. mychart.uwmedicine.org Valley Medical Center Patient Financial Services P.O. Box 59148 Renton, WA 98058-2148 425.690.3578 FAX 425.690.9578 M-F 8:00 a.m. – 5:00 p.m. mychart.valleymed.org/#mychart Valley Medical Center Patient Financial Services 3600 Lind Ave SW, Suite 110Renton, WA 98057-4970 425.690.3578 FAX 425.690.9578 M-F 8:00 a.m. – 5:00 p.m. mychart.valleymed.org/#mychart Airlift Northwest Patient Financial Services 6505 Perimeter Road S., Ste 200Seattle, WA 98108 206.598.2912 FAX 206.521.1612 M-F 8:00 a.m. – 5:00 p.m.