Financial Assistance Program
Windham Hospital provides financial assistance for certain qualified patients who are unable to pay all or part of their hospital bill. Financial assistance is based on your income, assets, and number of dependants in your family as described in the income guideline chart below. Financial Assistance is given for Windham Hospital charges only. Arrangements to pay your Physician, Radiologist, ER Physician, Anesthesiologist or Pathologist must be made separately to those providers.
If you think you are eligible for these services and would like an application, please call 860-456-6706 or 860-456-6109 Monday-Friday to speak with a Financial Counselor or make an appointment to speak with a Financial Counselor at Windham Hospital on the first floor located at 112 Mansfield Avenue, Willimantic, CT 06226. After you have completed an application, you will be notified whether it has been approved or denied. If your application is denied you may reapply as additional funds may become available on a yearly basis or your financial circumstances change.
| FAMILY SIZE ** | ADJUSTED GROSS INCOME
Effective Date: 4/01/2010 |
| # | Category A
Incomes below the
Max Family Income
may be eligible for
up to 100% Free Hospital Care Category B
Uninsured Patients with Incomes between the
Family Income listed below
may be eligible
for 50% Cost Reduction of Hospital Care |
| | Max Family
Income (Gross)Max Family
Income (Gross) |
| 1 | $10,400$10,401 - $26,000 |
| 2 | $14,000$14,001 - $35,000 |
| 3 | $17,600$17,601 - $44,000 |
| 4 | $21,200$21,201 - $53,000 |
| 5 | $24,800$24,801 - $62,000 |
| 6 | $28,400$28,401 - $71,000 |
| 7 | $32,000$32,001 - $80,000 |
| 8 | $35,600$35,601 - $89,000 |
| ** For family units with more than eight members add $3,600 for each additional member. |
|