CAPITAL HEALTH REGIONAL MEDICAL CENTER

"Income Eligibility Criteria - Patients with family gross income less than or equal to 200% of the Federal Poverty Guidelines ("FPG") are eligible for 100% Charity Care coverage."

documented · checked 2026-10-10 · CAPITAL HEALTH SYSTEM

"An uninsured patient is defined as a patient that has no insurance coverage for their medically necessary services and is not eligible for any State, Federal and local programs."

documented · checked 2026-10-10 · CAPITAL HEALTH SYSTEM

"[Click here](https://www.capitalhealth.org/sites/default/files/2018-04/FAP%20Form%20from%20FI%20006%20Charity%20Care%20Policy%20Jan%202016%20-%20FINAL.pdf)to download/print Capital Health's Financial Assistance Application Form."

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"1. Proper patient and family identification documents: This can include any of the following: driver's license, social security card, alien registry card, birth certificate, passport, visa, state issued identification, etc. 2. Proof of New Jersey Residence as of the date of service: This can include any of the following: driver's license, welfare plan identification card, utility bill, Federal income tax return, state income tax return, or an unemployment benefits statement (note: emergency care is an exception to the residency requirement). 3. Proof of gross income: This can include pay stubs, W-2's, unemployment benefit statements, etc. 4. Proof of assets as of the date of service: These are items which are readily convertible into cash. They include bank statements, investment statements, etc."

documented · checked 2026-10-10 · CAPITAL HEALTH SYSTEM

"**How to Apply** – FAP and the related Application Form may be obtained/completed/submitted as follows: 1. Obtained at Capital Health's main Outpatient Registration desk. 2. Request documents be mailed to you, by calling Capital Health's Patient Accounts Department at 609-394-6023. 3. Download the documents from the Capital Health website 4. Mail completed applications (with all documentation/information specified in the application instructions) to: Capital Health Patient Accounts Department, 750 Brunswick Avenue, Trenton, NJ 08638"

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"For help, assistance or questions, please call the Capital Health Patient Accounts Department at 609-394-6023."

documented · checked 2026-10-10 · Financial Assistance | Capital Health Hospitals

"Capital Health serves the emergency and other medically necessary healthcare needs of everyone, regardless of ability to pay in accordance with its policy on Emergency Care (Policy No. CCP-PC-002) and the Emergency Medical Treatment and Labor Act (EMTALA)."

documented · checked 2026-10-10 · CAPITAL HEALTH SYSTEM