For all programs, “family” is defined as the patient, the patient’s spouse, and all of the patient’s children under the age of 18 (natural or adoptive) who live in the patient’s home. A family’s gross income for the three months or twelve months prior to the date(s) of service will be used to determine eligibility.
 
Hospital Care Assurance Program
Licking Memorial Hospital provides basic, medically necessary, hospital-level services free of charge to Ohio residents with incomes at or below the federal poverty guidelines. To be eligible for the Hospital Care Assurance Program you must:

• Be ineligible to receive Ohio Medicaid coverage
• Be an Ohio resident
• Have a family size and household income at or below the federal poverty guidelines

Financial Assistance
Patients who earn up to 250 percent of the federal poverty guidelines may be eligible for financial assistance. To be eligible for this program you must:

• Be ineligible to receive Ohio Medicaid coverage
• Be a Licking County resident
• Have a family size and household income no more than 250 percent of the federal poverty guidelines

A Financial Assistance Application must be completed by the patient or the responsible party.  Applications are available here or through an individual’s MyChart account.  An application also may be obtained by contacting Patient Financial Services at (220) 564-1500.
 
Please view full policy details by reviewing the Financial Assistance Policy.  A Financial Assistance Policy Summary is available with more information on determining eligibility for financial assistance.