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Billing & financial services

 

Financial assistance

Salem Health is committed to making sure our patients get the hospital care they need regardless of their ability to pay for that care. Providing health care to those who cannot afford to pay is part of our mission, so we provide free and discounted care to eligible patients.

You may qualify for free or discounted care based on family size and income, even if you have health insurance.

 

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Do you qualify?

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How to apply for financial assistance

Any patient may apply to receive financial assistance/help with medical bills by submitting an application form (found below) and providing supporting documentation. If you have questions, need help, or would like to request more information, please contact us.

We offer over-the-phone screenings for financial assistance and the Oregon Health Plan (OHP). You can also apply for OHP by calling their application center at 800-699-9075.


Complete all three steps below to successfully submit your financial assistance application.

You may also apply online with MyChart. (MyChart login required.)

 

Application

Download and review the application documents in your language.


Download English application

Download Spanish application


Download Russian application



Documents

To process your application, you must provide one of the following:


Option 1

Current year federal tax filing

We need all pages and schedules of the current year's tax filing. If you own a business, please include current year business/corporation taxes. Please do not send hand written taxes, W-2’s, or state taxes, as we cannot accept these documents.

Option 2

Non-filing verification letter from the IRS

If you did not file a current year tax return, you will need to get a non-filing verification letter from the IRS. You may call the IRS at 1-800-829-1040 to request the letter or visit your local IRS office to request that letter.


Additional documents

In addition to one of the documents above, you also might be required to submit more documentation along with your application.

 

Submit

Complete and return the application and your supporting documents.


We will contact you within 21 days of receiving your application.







How to appeal a
financial assistance decision

You can appeal if you applied for financial assistance and disagree with our decision on your eligibility.

To appeal:

Fill out the Financial Assistance Appeal Request Form in your language.

Email the completed request form to financialcounselors@salemhealth.org or fax it to 503-814-1998.

 

Discounts and payment plans

Any balance for amounts owed by you is due within 30 days. The balance can be paid in any of the following ways: credit card, payment plan, cash, check, or online bill pay.


Catastrophic discount


We offer a 100% discount of balances greater than 20% of gross family income.



Uninsured discount


We offer a 50% discount for patients who do not have health insurance coverage.



Payment plans


Choose a payment plan in MyChart or call us at 503-814-2455.




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2024 FY25Q1 provider list

Click to download a list of providers who do and do not participate in financial assistance determination.

NOTE: Providers that do not follow the hospital's financial assistance policy may have their own financial assistance policies, so please contact the provider directly if you have any questions regarding their policies.

Contact us

Monday through Friday, except holidays and furloughs 8:30 a.m. to 4 p.m., closed noon to 1 p.m. for lunch.