Financial Assistance Program
It is the philosophy and policy of Day Kimball Hospital that medically necessary health care services should be available to all individuals regardless of their ability to pay.
Day Kimball Hospital is proud to offer financial assistance to patients who:
- Do not have insurance coverage and do not qualify for State Medicaid assistance
- Are insured but have financial hardship in meeting their remaining account balances
This program offers discounts on a sliding scale basis to patients with family income levels up to 400 times the Federal Poverty Income Guidelines as outlined below:
Size of
Family Unit |
2008 Federal Poverty Income Level |
Day Kimball Hospital Financial Assistance Program Effective March 1, 2009
(Family income up to 400% of Federal Poverty Level)
|
| 1 |
$10,400 |
Less than or equal to $43,320 |
| 2 |
$14,000 |
Less than or equal to $58,280 |
| 3 |
$17,600 |
Less than or equal to $73,240 |
| 4 |
$21,200 |
Less than or equal to $88,200 |
| 5 |
$24,800 |
Less than or equal to $103,160 |
| 6 |
$28,400 |
Less than or equal to $118,120 |
| 7 |
$32,000 |
Less than or equal to $133,080 |
| 8** |
$35,600 |
Less than or equal to $148,040 |
** For each additional person add $3,740
Please note that additional asset and/or income verification guidelines may apply depending upon the applicant’s determined income percentage of the current Federal Poverty Level.
If you are interested in applying for our DKH Financial Assistance program, please complete this application and return it to:
Day Kimball Hospital
Patient Financial Services
Attention: Financial Counseling
320 Pomfret Street
Putnam, Connecticut 06260
For any additional questions or if wish to speak with a representative regarding all of the available financial assistance programs at Day Kimball Hospital, please contact the Patient Financial Counseling Department at 860-963-6337, option #2, Monday through Friday between 8:00A.M. and 5:30 P.M. (except holidays) or email our financial counseling department at Patient_Financial_Counselor@daykimball.org
Click Here for Instructions on Completing the Free Health Care Application
Click Here for the Financial Assistance Application