As part of its commitment to serve the community and provide quality medical care to all of our patients, Baylor Scott & White Health provides a Financial Assistance Program to patients who satisfy certain requirements. This includes patients who don't have health insurance and can't pay their bill as well as patients who have coverage with an insurance carrier but are unable to pay their portion of the bill after insurance pays.
If you believe you qualify for financial assistance and have not spoken with a financial counselor or received a discount, then you should complete Baylor Scott & White's Financial Assistance Application through any of the following options:
Talk to a Baylor Scott & White financial counselorDownload and print the paper application. Please be sure to attach the application along with the appropriate supporting documentation when: Dropping off your application with a Baylor Scott & White financial counselor at any one of our hospitals Mailing your application to: ATTN: Financial Assistance Program Application
301 N Washington Ave
Dallas, TX 75246
Eligibility for financial assistance only applies to emergency and other medically necessary care.
Patients may apply for financial assistance from the date a patient is scheduled for service through the 365th day after the first billing statement is provided. However, eligibility for financial assistance only applies to emergency and other medically necessary care. Only United States citizens and residents of the United States are eligible for financial assistance. Financial assistance eligibility for non-emergency, medically necessary care is limited to patients residing in the service area defined in Attachment D of Baylor Scott & White's Financial Assistance policy, which includes all counties covered in BSWH Community Health Needs Assessments and otherwise where BSWH owns or operates licensed hospitals or provider-based clinics, as long as the facility providing the patient’s care is the closest facility (including non-BSWH affiliated facilities) to patient’s residence that can provide such medically necessary care or patient demonstrates that the closest facility cannot or will not provide such care. However, all patients, regardless of residency, will be eligible to qualify for financial assistance for emergency care and for non-emergency, medically necessary care provided after a BSWH facility accepts a transfer from a BSWH facility or a non-BSWH facility. Each eligible patient’s situation will be evaluated according to relevant circumstances, such as income or other resources available to the patient or patient’s family when determining the ability to pay the patient account balance. When a patient’s circumstances do not satisfy the requirements under the Financial Assistance Eligibility Discount Guidelines or Eligibility Criteria, a patient with unusual mitigating factors may still be able to obtain financial assistance. In these situations, the Financial Assistance Committee will review all available information and make a determination on the patient’s eligibility for financial assistance. The patient must provide information regarding the patient’s financial status and complete an application to be qualified for assistance. If you do not meet the income limits and cannot pay your bill, Baylor Scott & White offers an extended, interest-free payment plan to those patients. Please note: Except indicated in the BSWH Provider List (Attachment C) of Baylor Scott & White's Financial Assistance policy, the financial assistance offered under this Policy does not apply to services provided by any physicians or other professionals. If you received services from a HealthTexas Provider Network (HealthTexas) physician, you may be eligible for Baylor Scott & White's Financial Assistance Program. For more information, please visit HealthTexas' website and read more about HealthTexas' financial assistance policy.
1 Adults: In calculating the Household Size, include the patient, the patient’s spouse, and any dependents (as defined by the Internal Revenue Code (IRC)).
Minors: In calculating the Household Size, include the patient, the patient’s mother, the patient’s father, dependents of the patient’s mother, and dependents of the patient’s father.
2 Adults: If the patient is an adult, “Yearly Household Income” means the sum of the total yearly gross income or estimated yearly income of the patient and the patient’s spouse.
Minors: If the patient is a minor, "Yearly Household Income" means the sum of the total yearly gross income or estimated yearly income of the patient, the patient's mother and the patient's father.
Patients may apply for financial assistance from the date a patient is scheduled for service through the 365th day after the first billing statement is provided. However, eligibility for financial assistance only applies to emergency and other medically necessary care. Only United States citizens and residents of the United States are eligible for financial assistance. Financial assistance eligibility for non-emergency, medically necessary care is limited to patients residing in the service area defined in Attachment D of Baylor Scott & White's Financial Assistance policy, which includes all counties covered in BSWH Community Health Needs Assessments and otherwise where BSWH owns or operates licensed hospitals or provider-based clinics, as long as the facility providing the patient’s care is the closest facility (including non-BSWH affiliated facilities) to patient’s residence that can provide such medically necessary care or patient demonstrates that the closest facility cannot or will not provide such care. However, all patients, regardless of residency, will be eligible to qualify for financial assistance for emergency care and for non-emergency, medically necessary care provided after a BSWH facility accepts a transfer from a BSWH facility or a non-BSWH facility. Each eligible patient’s situation will be evaluated according to relevant circumstances, such as income or other resources available to the patient or patient’s family when determining the ability to pay the patient account balance.
When a patient’s circumstances do not satisfy the requirements under the Financial Assistance Eligibility Discount Guidelines or Eligibility Criteria, a patient with unusual mitigating factors may still be able to obtain financial assistance. In these situations, the Financial Assistance Committee will review all available information and make a determination on the patient’s eligibility for financial assistance.
The patient must provide information regarding the patient’s financial status and complete an application to be qualified for assistance. If you do not meet the income limits and cannot pay your bill, Baylor Scott & White offers an extended, interest-free payment plan to those patients.
Please note: Except indicated in the BSWH Provider List (Attachment C) of Baylor Scott & White's Financial Assistance policy, the financial assistance offered under this Policy does not apply to services provided by any physicians or other professionals.
If you received services from a HealthTexas Provider Network (HealthTexas) physician, you may be eligible for Baylor Scott & White's Financial Assistance Program. For more information, please visit HealthTexas' website and read more about HealthTexas' financial assistance policy.
To find out if you qualify, please provide the following information during your application process:
1 Adults: In calculating the Household Size, include the patient, the patient’s spouse, and any dependents (as defined by the Internal Revenue Code (IRC)).
Minors: In calculating the Household Size, include the patient, the patient’s mother, the patient’s father, dependents of the patient’s mother, and dependents of the patient’s father.
2 Adults: If the patient is an adult, “Yearly Household Income” means the sum of the total yearly gross income or estimated yearly income of the patient and the patient’s spouse.
Minors: If the patient is a minor, "Yearly Household Income" means the sum of the total yearly gross income or estimated yearly income of the patient, the patient's mother and the patient's father.