HEALDSBURG HOSPITAL
HEALDSBURG, CA · version 1 · published · JSON
eligibility.free_care_max_fpl300% of the federal poverty level"Annual family income, adjusted for family size, is at or below 300% of the current FPL guidelines, The patient is determined to be financially indigent and qualifies for Charity Care 100% write-off on patient responsibility amounts for Eligible Services."
documented · checked 2026-10-11 · Financial Assistance Policy – English
eligibility.insured_patients_coveredYes"Financial assistance is available to both uninsured and insured patients if they meet the requirements of this policy."
documented · checked 2026-10-11 · Financial Assistance Policy – English
programs.presumptiveMedicaid"Patients who are participating in state Medicaid programs are eligible for presumptive assistance."
documented · checked 2026-10-11 · Financial Assistance Policy – English
apply.documents_requiredProof of incomeTax return
Pay stubs
"Documentation of income will be limited to recent pay stubs or income tax returns."
documented · checked 2026-10-11 · Financial Assistance Policy – English
apply.submit_methodsMail: Send your completed application to: Healdsburg District Hospital Attn: Financial Assistance 1375 University Avenue Healdsburg, CA 95448In person: advise patient financial services staff at or prior to the time of discharge that assistance is requested
Portal: by visiting www.providence.org/financialhelp
"Patients may request and submit a Financial Assistance Application, which is free of charge and available at the Providence facility, or by the following means: advising patient financial services staff at or prior to the time of discharge that assistance is requested, by mail, or by visiting www.providence.org/financialhelp."
documented · checked 2026-10-11 · Financial Assistance Policy – English
apply.window_days_from_first_bill240 days"The FAP-Eligible Time Period for (i) hospital services is the 240-day period of time; and (ii) clinic services is the 90-day period, in each case that a patient has to submit a Financial Assistance Application to Providence."
documented · checked 2026-10-11 · Financial Assistance Policy – English
apply.decision_days30 days"Patients will receive notification of FAP eligibility determination within 30 days of submission of the completed Financial Assistance Application and necessary documentation."
documented · checked 2026-10-11 · Financial Assistance Policy – English
contacts.languagesEnglishEspañol
"* Languages + [English](https://www.providence.org/locations/norcal/healdsburg-district-hospital/patients-and-visitors/billing) + [Español](https://es.providence.org/locations/norcal/healdsburg-district-hospital/patients-and-visitors/billing)"
documented · checked 2026-10-11 · Billing | Healdsburg Hospital | Providence
coverage.facilitiesHealdsburg Hospital"Providence Hospitals in Northern California Providence St. Joseph Hospital Providence Redwood Memorial Hospital Providence Santa Rosa Memorial Hospital Providence Queen of the Valley Medical Center NorCal Health Connect Hospitals Petaluma Valley Hospital Healdsburg Hospital"
documented · checked 2026-10-11 · Financial Assistance Policy – English
Sources
HEALDSBURG DISTRICT HOSPITAL — fetched 2026-10-11
Billing | Healdsburg Hospital | Providence — fetched 2026-10-11
Financial Assistance Policy – English — fetched 2026-10-11
Learn more about your rights — fetched 2026-10-11