PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICY

Rehabilitation Hospital of Indiana (RHI) is committed to the healthcare needs of its patients regardless of the patient’s ability to pay.  This is a summary of our Financial Assistance Policy (FAP).

Eligibility Requirements – Financial assistance eligibility requirements are based on household income and number of family members.  Generally, patients with household income equal to or less than 200% of the Federal Poverty Guidelines (FPG) receive free care, and patients with household income between 200% and 400% FPG receive discounted care based on a sliding scale.  RHI also provides a discount to medically indigent patients.  All third party resources and non-hospital financial aid programs must be exhausted before financial assistance can be granted.  No person eligible for financial assistance under the FAP will be charged more for emergency or other medically necessary care than amounts generally billed to individuals who have insurance covering such care.   

How to Apply for Assistance – Patients may apply for financial assistance by completing a FAP application form and submitting it to the Patient Financial Services (PFS) department at the contact information listed below.

Where to Obtain Information – To obtain the Financial Assistance Policy,  Financial Assistance Application , or assistance in applying:

• Download online at www.rhin.com;
• Request by writing RHI at 4141 Shore Drive, Indianapolis, IN  46254 (Attention PFS);
• Visit the information desk at any of the RHI locations listed in the FAP;
• Request by telephone by calling the PFS department at (317) 329-2325;
• Notify your care coordinator

Translations – The FAP, FAP application, and this summary are available in English and Spanish (FAP, FAP application, summary).