WVU Medicine is dedicated to ensuring every patient receives the necessary medical care, regardless of their financial situation. Recognizing that healthcare costs can be a burden, they offer a robust financial assistance program, often referred to as the Wvu Cares Program, to support those who qualify. This program aims to provide peace of mind, allowing patients to focus on their health and recovery without the added stress of overwhelming medical bills.
Who is Eligible for the WVU Cares Program?
The WVU Cares Program at WVU Medicine is designed to assist patients who meet specific eligibility criteria. These guidelines ensure that financial assistance reaches those with genuine need. To be considered eligible for the program, patients generally need to meet the following requirements:
- Need for Medically Necessary Care: The program covers patients who have received or are scheduled to receive emergency or medically necessary medical services. This ensures that essential healthcare is accessible.
- Income Limitations: Households with an income less than twice the federal poverty limit are typically eligible. This income threshold is a key factor in determining financial need. For specific income guidelines, you can refer to the federal poverty limit documentation.
- Limited Assets: Patients should not possess substantial assets that could be used to cover medical expenses. This criterion ensures the program supports those with limited financial resources.
- Medicaid Denial: Applicants are generally required to have applied for and been denied Medicaid coverage. This step ensures that the WVU Cares Program serves as a safety net for those who have explored other avenues of assistance.
- Residency Status: Eligibility is generally limited to citizens or permanent residents of the United States.
- International Student Considerations: International students may also qualify under certain conditions, particularly if they possess a student visa and have primary insurance coverage.
It’s important to note that even if a patient doesn’t strictly meet all of these guidelines, WVU Medicine may consider individual cases for exceptions based on unique circumstances.
How to Apply for Financial Assistance through the WVU Cares Program
Applying for the WVU Cares Program is a straightforward process. WVU Medicine aims to make it as easy as possible for patients to access the financial support they need. Here’s how you can apply:
- Download the Application: The first step is to obtain the financial assistance application form. You can easily download a copy of the application online.
- Complete the Form: Ensure all sections of the application form are filled out accurately and completely. Incomplete applications may experience delays in processing.
- Gather Required Documentation: Collect all necessary documentation as specified in the application instructions. This typically includes proof of income, residency, and any other relevant financial information.
- Submit Your Application: Once completed, the application and supporting documents should be returned by mail to the address provided on the form.
If you require assistance with completing the application or wish to discuss your situation with a financial counselor, WVU Medicine encourages you to reach out. You can contact a financial counselor by phone or in person during business hours (Monday – Friday, 8 am – 4:30 pm). Contact numbers are available for various WVU Medicine locations:
WVU Medicine Locations: 304-598-6260
Garrett Regional Medical Center: 301-334-4179
You can also visit the Garrett Regional Medical Center Billing page for further information specific to that location.
What Healthcare Services are Covered by the WVU Cares Program?
The WVU Cares Program is comprehensive in its coverage of essential medical services. It is designed to alleviate financial concerns related to necessary treatments. Key aspects of coverage include:
- Emergency and Medically Necessary Care: All emergency and medically necessary healthcare services are covered under the program. This encompasses a wide range of treatments deemed essential for patient health.
- Coverage Duration: Once your application is approved, the financial assistance coverage is typically valid for six months. Patients need to re-apply after this period if continued assistance is needed.
It is important to be aware that while the WVU Cares Program is extensive, some services may be excluded. For a detailed list of excluded services, you can view the complete list. If you have any questions regarding specific services and their coverage, contacting a financial counselor is recommended.
Accessing the Full Financial Assistance Policy Details
For a complete and detailed understanding of the WVU Cares Program, WVU Medicine makes its full financial assistance policy readily accessible to patients and the public. You can obtain the policy through several convenient methods:
-
Online PDF Version: The entire policy document is available in PDF format online. You can view a PDF copy at your convenience.
-
Contact a Financial Counselor: Calling a financial counselor at the numbers provided is another way to get detailed information about the policy. They can answer your questions and provide clarifications.
-
Request by Mail: You can request a physical copy of the policy to be mailed to you. Send your request to:
WVU Medicine – Hospital Services
PO Box 8031
Morgantown, WV 26506 -
In-Person Request: Copies of the financial assistance policy are also available at hospital admissions areas and registration desks within the Emergency Department at WVU Medicine locations.
What if You Don’t Qualify for Full Financial Assistance?
WVU Medicine understands that financial situations vary, and even if you don’t qualify for full financial assistance under the WVU Cares Program, there may still be options available to help manage healthcare costs.
- Discounted Care: Patients who do not qualify for 100 percent assistance may still be eligible for discounted care. This reduces the financial burden and makes healthcare more affordable.
- Uninsured Discount: If you are uninsured, WVU Medicine offers a significant discount, charging 50 percent of billed charges for hospital services. This discount is designed to ensure fair pricing compared to amounts typically billed to insured patients.
- Physician Bill Discounts: Discounts may also be available for physician bills. Contact 304-285-7100 or 800-541-4009 for details on physician discounts.
- Insured Patient Discounts: Even with insurance, additional discounts might be available. Financial counselors can provide information on these options. Contact them at 855-778-2922.
For further resources and information, WVU Medicine’s Billing Resources section provides helpful forms and additional details.
Understanding Amounts Generally Billed (AGB)
WVU Medicine is committed to fair and transparent billing practices. To ensure this, they calculate Amounts Generally Billed (AGB). This calculation is crucial for determining appropriate discounts and ensuring that uninsured patients are not overcharged.
WVU Medicine employs the “look-back” method to calculate AGB. This method is based on analyzing past claims data. Specifically, it considers actual past claims paid to WVU Medicine hospitals by:
- Medicare fee-for-service: Payments from traditional Medicare.
- Private health insurers: Payments from all private health insurance companies.
The current AGB calculation is based on payments received during calendar year 2021 for inpatient and outpatient acute services. This ensures the discounts are grounded in real-world payment data, reflecting typical billing amounts.
In conclusion, the WVU Cares Program and WVU Medicine’s broader financial assistance efforts demonstrate a commitment to patient care that extends beyond financial barriers. By offering various forms of assistance and ensuring transparent billing practices, WVU Medicine strives to make quality healthcare accessible to everyone in the community. If you believe you might be eligible for assistance or have questions, reaching out to a WVU Medicine financial counselor is the recommended next step.
