Peninsula Regional Medical Center aims to make available to all patients the highest quality of medical care possible within the resources available. If a patient is unable to pay due to financial resources, all efforts will be made to help the patient obtain assistance through appropriate agencies, or, if no help is available, to render care at a reduced or zero cost for emergency and medically necessary care.

Applications can be taken orally by calling 1-877-729-7762 between 8:00 a.m. and 5:00 p.m., Monday through Friday; or in person at the Financial Counselor’s office (located in the Frank B. Hanna Outpatient Center lobby) between 8:00 a.m. and 4:00 p.m., Monday through Friday.

You may also download and fill out the application below, or read more about our policies by clicking on the documents.

Financial Assistance Application

Financial Assistance Application (Español)

Plain Language Summary

Plain Language Summary (Español)

Financial Assistance Policy

Financial Assistance Policy (Español)

Provider Eligibility for Financial Assistance

Patient Collection Practice

Patient Collection Practice (Español)

Federal Poverty Guidelines

Emergency Medical Treatment and Active Labor Act (EMTALA)