LifeBridge Health Financial Assistance

Financial hardship doesn't have to be an obstacle to your care


Do you need help paying your hospital bill?

LifeBridge Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression. LifeBridge Health does not exclude people or treat them differently because of race, color, national origin, age, disability, sex or sexual orientation and gender identity/expression.

How To Apply

Mail:

LifeBridge Health,
Attn: Customer Service
5401 Old Court Road
Randallstown, MD 21133
Phone:
1-800-788-6995
Fax:
800-368-1019


Financial hardship doesn't have to be an obstacle to your care. LifeBridge Health hospitals (Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Hospital and Nursing Center, and Grace Medical Center) can provide assistance, including discounts, to financially disadvantaged patients (including the uninsured or underinsured) who qualify.

Eligibility

Patients and families with an annual income up to 300% of the Federal Poverty Level may qualify for discounts up to 100% of their hospital bill.

For example, you may qualify if your income is lower than the amounts applicable to your family size in the table below (for each additional person, add $1,285 monthly or $15,420 annually):

Uninsured & Underinsured 100% Discount
Family Size Earnings Period up to 300% FPL
1 Monthly $3,645.00
Annual $43,740.00
2 Monthly $4,930.00
Annual $59,160.00
3 Monthly $6,215.00
Annual $74,580.00
4 Monthly $7,500.00
Annual $90,000.00
5 Monthly $8,785.00
Annual $105,420.00

Which Providers and Hospitals Participate?

Each LifeBridge Health hospital participates in the Financial Assistance Program. However, charges for physician services are billed separately and may not be covered by our financial assistance policy. For more information about services and providers covered under our policy, please visit Financial Assistance Policy.

How to apply

Applying is simple. You can request a financial assistance application by calling Customer Service at (800)788-6995, visiting the Customer Service area at the hospital where you received care, or asking a registration representative. You can personally submit your completed application to Customer Service or a registration representative, fax it to (401)601-4031 or mail it to:

Attn: Customer Service
5401 Old Court Road
Randallstown, MD 21133
Please note that additional documentation may be requested in order to help us make a determination. Most determinations are completed within 14 business days. You will receive either a letter by mail or a telephone call about your eligibility. For additional information, call Customer Service at 1-800-788-6995

More Information:

Plain Language Summary

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Financial Assistance Application

English Spanish Russian French

Financial Assistance Policy

English Spanish Russian French

Billing and Collections Policy

English Spanish Russian French

Services and Providers Covered Under the Financial Assistance Policy

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