KETTERING HEALTH DAYTON

"Extended Financial Assistance-the individual’s household income must be at or below 250% of the current Federal Poverty Limits (FPL) to be eligible for 100% reduction from applicable charges."

documented · checked 2026-10-13 · PF-KH FINANCIAL ASSISTANCE

"KH Sliding Scale: PROGRAM % FPL DISCOUNT HCAP 0% - 100% 100% Financial Assistance – Extended 0% - 250% 100% Financial Assistance – Basic 251% - 400% 80%"

documented · checked 2026-10-13 · Financial Assistance Policy

"This results in a full adjustment to billed charges for individuals with no insurance or a full adjustment to billed charges for individuals with insurance with a remaining patient responsibility after insurance pays."

documented · checked 2026-10-13 · PF-KH FINANCIAL ASSISTANCE

"Forward application and all applicable documents to: Kettering Health Financial Assistance P.O. Box 933310 Cleveland, OH 44193, Email: FinancialCounselors@ketteringhealth.org or fax (937) 522-9944."

documented · checked 2026-10-13 · Patient Application for Financial/Medication Assistance

"Proof of income documentation accepted: check stubs, tax return/1099/W2’s, social security/pension/VA statements, court documents, and other documents for income proof as reported below."

documented · checked 2026-10-13 · Patient Application for Financial/Medication Assistance

"Forward application and all applicable documents to: Kettering Health Financial Assistance P.O. Box 933310 Cleveland, OH 44193, Email: FinancialCounselors@ketteringhealth.org or fax (937) 522-9944."

documented · checked 2026-10-13 · Patient Application for Financial/Medication Assistance

"Financial assistance application will be considered up to 240 days after the first post discharge billing statement."

documented · checked 2026-10-13 · Financial Assistance Policy

"KH or its authorized agents will not initiate any ECAs for at least 120 days from the date KH provides the first post-discharge billing statement."

documented · checked 2026-10-13 · Financial Assistance Policy

"For additional questions call: (937) 914-7680"

documented · checked 2026-10-13 · Patient Application for Financial/Medication Assistance

"Financial Assistance Policy, Financial Assistance Application Form and Plain Language Summary of the Financial Assistance Policy are transparent and available to the individuals served in English and Spanish languages."

documented · checked 2026-10-13 · PF-KH FINANCIAL ASSISTANCE

"KH adopts this policy for Kettering Health Main Campus, Kettering Health Miamisburg, Kettering Health Dayton/Kettering Health Washington Township, Kettering Health Greene Memorial, Soin Medical Center, Kettering Health Hamilton, Kettering Health Troy, all hospital off-sites, and KH Support Services."

documented · checked 2026-10-13 · PF-KH FINANCIAL ASSISTANCE