Financial Assistance
St. Luke's Health understands that paying for emergency and medically necessary medical care can be difficult, particularly for patients who lack health insurance. As part of our ongoing commitment to our patients, we have worked with CommonSpirit Health (our system organization) to help our patients address their financial responsibilities in a fair and sensitive way to their circumstances. We have instituted a program designed specifically to help those who find themselves in financial distress.
The Program
The CommonSpirit Health Financial Assistance Policy (available in multiple languages) applies to uninsured/underinsured patients who come to our facilities for treatment. This policy provides financial relief to patients who qualify based on comparing their financial resources and income to Federal Poverty Guidelines. The program is designed specifically for emergent/urgent and medically necessary care patients whose household financial resources and income are at or below 400 percent of the Federal Poverty Level.
To qualify for any assistance, uninsured/underinsured patients will be asked to complete a CommonSpirit Health Financial Assistance Application (available in multiple languages), including household income and expenses.
We are committed to working with our patients to establish an appropriate payment plan based on the amount due and the patient's financial status.
Financial Assistance Forms and Policies
Financial Assistance Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Collections Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Summary - Plain Language Summary
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Mailing address:
CHI St. Luke's Health
Eligibility and Enrollment Services
P.O. Box 660872, Dallas, TX 75266-0872
Financial Assistance Application
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Mailing Address:
CHI St. Luke's Health
Eligibility and Enrollment Services
P.O. Box 660872, Dallas, TX 75266-0872
Addendum Financial Assistance Policy Contact
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Questions?
For questions regarding our policy or form(s), please call 832.355.8275 or 844.490.1247.
Provider Listings
Financial Assistance Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Collections Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Summary - Plain Language Summary
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Application
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Addendum Financial Assistance Policy Contact
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Questions?
For questions regarding our policy or form(s), please call 979.299.2882.
Provider Listings
Financial Assistance Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Collections Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Summary - Plain Language Summary
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Application
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Addendum Financial Assistance Policy Contact
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
If you qualify for partial support from CommonSpirit Health, learn the amounts generally billed/reimbursed for services at CommonSpirit Health.
Questions?
For questions regarding our policy or form(s), please call 713.378.7961.
Provider Listings
Financial Assistance Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Collections Policy and Procedure
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Summary - Plain Language Summary
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Financial Assistance Application
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
Addendum Financial Assistance Policy Contact
- Arabic
- German
- Spanish
- English
- French
- Hindi
- Hmong
- Japanese
- Korean
- Portuguese (Brazil)
- Russian
- Tagalog
- Vietnamese
- Simplified Chinese
- Traditional Chinese
If you qualify for partial support from CommonSpirit Health, learn the amounts generally billed/reimbursed for services at CommonSpirit Health.
Questions?
For questions regarding our policy or form(s), please call 844.286.5546.
Provider Listings
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