Financial Assistance

Citizens Memorial Hospital (CMH) gives financial assistance to those that qualify.

CMH Family Medicine

Plain Language Summary of CMH Financial Assistance Program

We share details about our Financial Assistance Policy on our statements, collection letters, website, and through signs at registration. Also, the Patient Accounts/Cashier Office, Financial Assistance Office, Registration and Social Services give out applications and tell patients that help is available. These offices are all located at the main Hospital at 1500 N Oakland Ave, Bolivar, MO.  The policy is also available on our website at citizensmemorial.com. View our complete Financial Assistance Policy.

If you need help completing the application for assistance or have questions about the documents needed, you may visit our Patient Accounts/Cashier office located near the main lobby of the Hospital at 1500 N Oakland Ave, Bolivar, MO or call CMH Customer Service at 800-326-0508 or 417-328-6508

We use current federal poverty guidelines (see table below) as a part of the calculations to determine how much help each patient will receive. We may not include services that are not medically necessary. Co-pays will be due at time of service.

The necessity for medical treatment of patients will be based on the clinical judgment of the provider without regard to the financial status of the patient.  Patients will be treated with respect and fairness regardless of their ability to pay.

If a patient is approved for financial help, that patient must set up a payment plan if the balance due cannot be paid in full. If a patient does not make the payments as agreed, we may send that patient’s accounts to a collection agency.

Patients approved for Financial Assistance will not be required to pay more than what is generally billed to insurance payers.

Download the Application For Financial Assistance or visit our website at citizensmemorial.com.

Contact

Still have questions about the Financial Assistance program or application? Call CMH Customer Service at 800-326-0508 or 417-328-6508 or visit our Patient Accounts/Cashier Office located just off the main lobby of the Hospital located at 1500 N Oakland, Bolivar, MO. 

Federal Poverty Guidelines

Family Size Income - 100% FPL 101% to 249% FPL 250% FPL
 1  $14,580  $14,581 to $30,288  $30,229
 2  $19,720  $19,721 to $49,102  $49,103
 3  $24,860  $24,861 to $61,901  $61,902
 4  $30,000  $30,001 to $74,700  $74,701
 5  $35,140  $35,141 to $87,498  $87,499
 6  $40,280  $40,281 to $100,297  $100,298
 7  $45,420  $45,421 to $113,095  $113,096
 8  $50,560  $50,561 to $125,894  $125,895
 Additional Person  $5,140  $5,140  $5,140
 % of discount  90%  89% to 1%  0%

Updated annually based on guidelines published by the U.S. Department of Health and Human Services.

Medicare Assistance

Missouri SHIP is the state's official State Health Insurance Assistance entity, providing free, unbiased and confidential services for Medicare recipients. SHIP volunteers provide Medicare counseling in their local communities. Visit the Missouri SHIP website or call 800-390-3330 for more information.